Solving Medicaid dilemma critical

Health care reformers, not to mention tens of millions of other Americans who understand money does not grow on trees, are caught between the proverbial rock and a hard place.

The rock is this: President Barack Obama’s signature health care takeover law encouraged states to expand the Medicaid program. Both at the state and federal levels, that is unsustainable.

Now for the hard place: Even some members of Congress who understand the Medicaid concern say they cannot vote for reform that would even halt expansion of the program where it is now.

Somewhere around 18 million people were added to Medicaid rolls by the Obamacare law. New enrollees go on the books every day. No one — least of all lawmakers from low-income states where Medicaid clients are huge voting blocs — has the political will to alienate that many people.

Senate Majority Leader Mitch McConnell, R-Ky., is well aware of the conundrum. It is why a House of Representatives health care reform bill went nowhere. It also is why McConnell has been unable to get the votes to pass an initial reform attempt in the Senate.

A new Senate reform bill was presented Thursday. McConnell wants a vote on it this week. But it does solve the Medicaid challenge. It would phase out enhanced federal financing for Obamacare’s Medicaid expansion and limit overall funding for the program in the future. It is estimated that 15 million fewer people will be covered by Medicaid by 2026. Republican governors whose states expanded their Medicaid coverage under Obamacare, have been criticizing the bill for that reason.

Without a solution to the Medicaid issue, the new and improved proposal may be doomed, too.