Tierney Sneed · Thursday, March 16, 2017, 6:22 am
The fights over how Republicans’ Obamacare repeal legislation changes or eliminates ACA-related provisions have made the loudest noise as the legislation has moved forward on Capitol Hill. But its biggest provision -- both in terms of budgetary impact and long-term effect on the health care system -- is its overhaul of Medicaid, a transformation that Republicans have sought long before the Affordable Care Act was passed in 2010.
Given the legislative limits GOP lawmakers face in fully repealing Obamacare and the struggles they’re having landing on a consensus ACA alternative, one could argue that the Obamacare repeal push is actually a trojan horse for the much more sweeping conversion of Medicaid, from an unlimited match rate into a system where federal funding will be limited on a per-enrollee-basis. Republicans are under immense political pressure, after years of campaign promises, to dismantle the ACA. But rather than tackle the 2010 bill on its own, they've used repealing it as a vehicle to attempt what they've wanted to do to Medicaid all along.