Sigh, like I have said in previous posts, I don't necessarily disagree that the states should take on more of the responsibility from the federal government in regards to some programs (including Medicaid). Yes, it is state managed but it was enacted with the passing of a federal act (through Title XIX of the Social Security Act) in 1965. That's part of the reason why the federal government is involved rightly or wrongly. And here's the thing, it's at least 50% funded with federal dollars at this time depending on the state you live in. So, if a state decides to opt out of Medicaid while instituting their own program they are going to have to cut costs by at least 50% in order to not have to allocate additional state funds to the new program (if they decide the same services should be provided). Based on what I have seen no states have a good solid proposal in place that would do such a thing, not even Texas (
Is Texas really thinking of opting out of Medicaid?). So, right now it just seems like a bunch of pie in the sky rhetoric at this time with a bunch of ranters and ravers saying they can do a better job at a significantly reduced cost. I'll wait and see, can't buy much into it at this time.