But in his opening remarks, Rep. Chris Van Hollen (D-Md.) said work incentives that led to welfare reform in 1996 are not relevant to Medicaid in particular. “First, it is a program that provides healthcare coverage to those left behind by the private insurance market,” Van Hollen said. “Second, two-thirds, or 66%, of Medicaid spending is for senior citizens and people too disabled to work, while another 20% is for children.”
Witnesses included policy experts who testified about topics such as marginal tax rates and means-tested welfare programs, including Medicaid. Robert Rector, a senior research fellow at the conservative Heritage Foundation, said federal spending on means-tested welfare, plus state contributions to federal programs, totaled about $927 billion last year. He suggested that Congress establish a cap or limit on the future growth of means-tested spending and that by 2013—at the latest—total means-tested welfare spending should return to pre-recession levels.
Although Ryan began the hearing lauding work requirements, he made it clear that his budget proposal has no such requirements for those on Medicaid. That plan calls for restraining Medicaid growth by about $810 billion over 10 years.
“Our budget does not impose on Medicaid work requirements or time limits,” Ryan said in the middle of the hearing. “That's not a proposal that's in our budget. The other point is: we're spending $100 billion next year on Medicaid alone,” he added. “So I know this is Washington talk. It's not being cut. It's not growing as fast as what the president's budget proposes, and yes, we do propose to repeal the president's healthcare law, which has a dramatic increase—but we're actually still increasing spending on Medicaid in our budget.”
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