02.15.13 3:30 PM ET
Wisconsin's Novel Approach to Medicaid Reform
Avik Roy lauds Governor Scott Walker's decision to circumvent the supposed binary choice between turning down Obamacare's expansion of Medicaid and receiving taxpayer dollars for accepting the choice:
Wisconsin has shown us that there is a third way, one that allows states to make the best of the “Sophie’s Choice” that Obamacare has imposed upon them. States’ focus should be on maximizing their use of Obamacare’s exchanges, which provide at least some semblance of market-based health coverage, and minimizing their use of Medicaid, which traps the poor in the worst health program in the developed world.
Many conservatives still hope that Obamacare can be repealed. But the chances of that happening are close to zero. Here’s the silver lining: Obamacare’s exchanges, while seriously flawed, are reformable in a way that Medicaid is not. Indeed, the exchanges could someday be expanded to provide coverage for people who are today on Medicare and Medicaid, resulting in true, long-term entitlement reform. Scott Walker’s plan is a small but important step toward that goal.
There it is: only by accepting that Obamacare is here to stay can conservatives reform the best parts of the bill and make life better for Americans. The alternative is to be against something that won't go away, and to let principle end in defeat after defeat.