The Medicaid Contrast

I have blogged before about the puzzling lack of attention to Romney-Ryan's swingeing Medicaid cuts in the current US presidential campaign, especially in contrast to the saturation coverage of Medicare. But lately things are looking up. There is now real hope that the Obama campaign, the media, and the electorate will begin to raise tough questions on Medicaid that Mitt Romney, Paul Ryan, and like-minded Republicans will have to answer.

Bill Clinton, in his terrific speech this Wednesday at the Democratic National Convention, ripped into the Romney-Ryan Medicaid cuts and -- realizing that the needs of the poor, who do not vote, tend to take a backseat to the needs of the elderly, who do -- made a masterly attempt to get elderly voters to wake up and notice how they too -- and not just the poor -- would be squeezed by the proposed cuts.

They also want to block grant Medicaid and cut it by a third over the coming decade. Of course, that will hurt poor kids, but that's not all. Almost two-thirds of Medicaid is spent on nursing home care for seniors and on people with disabilities, including kids from middle class families, with special needs like, Downs syndrome or Autism. I don't know how those families are going to deal with it. We can't let it happen.

The press, led by Abby Goodnough and Nina Bernstein of The New York Times, has begun paying more attention.

At The Washington Post, Sarah Kliff has documented Bill Clinton's point that a big chunk of Medicaid spending goes to providing long-term care for the elderly. Ezra Klein of The Washington Post has pointed out -- with a very nice chart -- that the big difference on healthcare policy between Obama and Romney is actually on Medicaid, not Medicare:

First thing you should notice: The difference on Medicare isn’t that large. It’s 0.75 percent of GDP. And note that the spending path Ryan wants to hold Medicare to — GDP+0.5% — is the exact same spending path that Obama wants to hold Medicare to.

The difference for Medicaid and other health programs — including the Affordable Care Act — is much larger. In fact, at 2.25 percent of GDP, it’s three times as large as the cut to Medicare. So that’s the first thing you need to know: Ryan’s main cut isn’t to health care for old people. It’s to health care for poor people.

Now it's up to Obama to stop pussyfooting around. He needs to pick up the Medicaid issue and go on the attack.

Update, September 8, 2012: Sarah Kliff further documents and emphasizes that Medicaid is not 'only' for the poor; it is a sizable middle-class entitlement as well.