The next two months will feature much discussion about Mitt Romney’s and Paul Ryan’s plan to turn Medicaid — the federal program to provide health care to the very needy, including many penniless seniors in nursing homes — into a single “block grant” to states to run their own programs. But one point is clear at the outset: This would be a bad deal for Massachusetts.
The Ryan plan, which has been endorsed by Romney, would cut federal Medicaid funding over the next decade by a third, according to the nonpartisan Urban Institute. Massachusetts would see its share drop from roughly $109 billion to $78 billion, in today’s dollars. That shift that would strain Massachusetts more than other states because seniors and disabled individuals are an outsized proportion of the Commonwealth’s Medicaid rolls — 44 percent, compared with just 35 percent nationwide. Most Medicaid spending goes toward those two demographics, a fact that Ryan doesn’t account for. He would tie the amount of state aid to overall population changes and inflation alone. The result for Massachusetts would be fewer funds for the most costly Medicaid enrollees.