The 50th anniversary of Medicare and Medicaid enactment calls for a celebration. Medicare provides health insurance protection to virtually all older Americans and many workers who become disabled. Medicaid is the nation's invaluable long-term-care safety net, helping anyone who can't afford services and support. Under the Affordable Care Act, states can rely on Medicaid to make healthcare available to all low-income Americans.
So what's not to celebrate? To those philosophically opposed to government, program expenditures are fiscally daunting. But that spending growth now and for the foreseeable future is extraordinarily low, largely driven by growth in their eligible populations.
Critics propose to reduce government's role and spending by radically restructuring both programs. They would replace Medicare's public insurance with vouchers to buy private plans. They would replace federal Medicaid funding grants that match state spending with fixed-dollar block grants. Both “reforms” would shift healthcare and cost risks from taxpayers to beneficiaries.