Politics is protecting Medicaid over Medicare

You read that right, and it’s the opposite of what usually happens. Usually Medicare is relatively more protected because its beneficiaries vote heavily. Meanwhile, Medicaid is cut to the bone because its beneficiaries don’t. But Sam Baker explains why the political fortunes have flipped, at least for now.

The push to prioritize Medicaid over Medicare is a result of the Supreme Court’s decision last year upholding the Affordable Care Act as constitutional. The decision gave states the ability to opt out of the law’s Medicaid expansion, which was set to provide about half of the law’s coverage expansion before the court’s ruling.

The federal government will initially cover the entire cost of the expansion, but some Republican governors don’t entirely trust Congress to follow through on those funding commitments. The White House is taking its Medicaid cuts — some of which would have shifted costs to the states — off the table to send a message to governors.

Governors who accept the expansion “should do so with the understanding that the rug will not be pulled out from them,” Sperling said Thursday.

It’ll be hard to recalibrate my political radar, but I’ll try. I bet the political fortunes will revert to their usual order at some point. The harder question is, when?

UPDATE: Aaron reminds me that the sequester specifically protects Medicaid. His comment: “MEDICAID! Unreal.”


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