Unlimited Access. Try it Today! Your First 10 Days Always $0.99

Readers Respond

News Opinion Readers Respond

The federal government's fiscal problems can't be fixed unless Medicaid is reformed

While Rep. Chris Van Hollen may wish that a deal to fix the federal government's fiscal problems could leave Medicaid untouched, the reality is that if the federal deficit is to be addressed, entitlement programs like Medicaid must be fundamentally reformed ("Debt crisis could hurt Maryland," July 17).

Under the current Medicaid system, in which the federal government gives Maryland a dollar-for-dollar match for every Medicaid dollar the state spends, there is little incentive to control costs. In fact, since 2000 spending on Maryland's medical care programs — primarily Medicaid — has increased by 185 percent.

That not only contributes to the federal fiscal crisis but also to Maryland's ongoing structural budget deficit. In 2000, 12.6 percent of the state's revenue was devoted to these programs. This fiscal year, over 17 percent of the state's revenue will go to pay for them.

With all this "free" federal money rewarding the state for spending more on its Medicaid program, it actually costs the state money if it tries to combat the rampant fraud plaguing Medicaid. An open-ended Medicaid entitlement also reduces Maryland's incentives to reform its health insurance regulations so that low-income Marylanders can afford coverage. Instead, the state keeps expanding Medicaid, bringing more people into a program that is noted for offering an extremely poor level of care.

The apocalyptic rhetoric Rep. Van Hollen uses to describe what would happen under Medicaid block grants recalls the overheated claims made by those who opposed welfare reform in the 1990s. Welfare reform did not lead to catastrophe, and neither will Medicaid reform. Given the state of the federal budget, it seems inevitable that Medicaid's structure will one day be changed. Let's do it now and start reaping both the health and fiscal benefits such a reform will bring.

Marc Kilmer,Rockville

The writer is a senior fellow at the Maryland Public Policy Institute.

Copyright © 2015, The Baltimore Sun
Related Content
  • Van Hollen is right: Medicaid cuts hurt everyone

    Contrary to Robert Erlandson's letter ( "Van Hollen shows why it will be so hard to reduce the deficit," July 26), Rep. Chris Van Hollen's op-ed ("Medicaid cuts would hurt us all," July 25) correctly pointed out the consequences of cutting Medicaid. As Rep. Van Hollen wrote, whenever uninsured...

  • Van Hollen shows why it will be so hard to reduce the deficit

    The article in today's Sun by Rep. Chris Van Hollen ("Medicaid cuts would hurt us all," July 25) demonstrates how difficult it will be to reduce our budget deficit. While giving lip service to the need to reduce our federal budget deficit, he then maintains that there should be no reduction in...

  • Van Hollen: In budget balancing, we must preserve Medicaid
    Van Hollen: In budget balancing, we must preserve Medicaid

    Top Democrat on the House budget committee, says health insurance for the poor has a tremendous economic impact

  • The U.S. is facing a crisis over jobs and growth, not debt

    A reader commenting on Rep. Chris Van Hollen's op-ed "Medicaid cuts would hurt us all" (July 25) bemoans his lack of commitment to seriously reduce the national debt. But his priorities and solution are questionable.

  • Why no talk of Gray's disabilities?
    Why no talk of Gray's disabilities?

    According to what I've read, Freddie Gray was exposed to lead in early childhood. This resulted in neurological damage, developmental impacts and learning disabilities. Yet, I have seen no discussion of how disability issues factored into the tragic events surrounding Freddie Gray's death ("Six...

  • Baltimore's fateful choice
    Baltimore's fateful choice

    The police need to make a calculated decision on how to proceed regarding the unrest in Baltimore, given there are risks associated with whatever path they take ("After charges against officers, Hopkins' students call for continued protests, dialogue on Freddie Gray," May 1).

  • Violence is not the answer
    Violence is not the answer

    I wanted to write to voice my opinion on the events that led to the death of Freddie Gray along with the protests that turned violent in Baltimore. In police custody, Gray incurred a spinal injury that later resulted in his death. Watching the news coverage of the videos, it is not clear who is...

  • Mayor failed to acknowledge mistakes
    Mayor failed to acknowledge mistakes

    As a consequence of the recent Baltimore protests and riots, there has been a lot of discussion about the leadership qualities of Mayor Stephanie Rawlings-Blake ("Who's in charge?" April 28). There is a fatal flaw in this debate. People are equating the quality of her leadership with decision-making....