Rutgers professor talks Medicaid



By Robert Arenella  On  February 18th, 2013

Medicaid took a front seat in the contentious 2012 election as both sides debated the pros and cons of the system, including its drain on federal spending money.

Monday in Weill Hall, Frank J. Thompson, professor of public affairs and administration at Rutgers University, defended the federal health aid system.

Thompson was promoting his new book “Fractious Federalism and the Future of Medicaid,” in which he evaluates how the Clinton, Bush and Obama administrations have affected Medicaid, federalism and health care reform.

The federal grant program insures more than 65 million low-income citizens across the country, while the government spends $400 billion of federal and state funds every year.

Thompson said most of the money is dedicated to intensive health programs.

“A lot of it — a majority of it — is going to long term care,” Thompson said.

In recent years, Medicaid and other government-provided health care have transitioned from a federal responsibility to a state-provided service. Thompson attributed this transfer to the use of waivers beginning in the 1990s, which created and tested new methods of providing care to citizens with Medicaid.

“The Clinton administration was a clear watershed moment in this regard,” Thompson said.

Thompson blamed growing distrust in government and its redistributive programs — originating in the 1960s — as the source of much of the pessimism surrounding Medicaid.

“(The public opinion has led to) a steady erosion in this sense that Medicaid is a legal entitlement to you,” Thompson said.

Thompson commended Medicaid on its improvement of services, including the transfer of care to home and community programs rather than institutions.

Despite these obstacles, Medicaid has expanded between 1992 and 2013. The Affordable Care Act of 2010, also known as Obamacare, has opened up health care to 30 million Americans. According to Thompson, 15 million are slated to gain benefits from Medicaid.

Thompson said the controversial nature of the Affordable Care of Act has had a polarizing effect on partisanship. Despite Republican opposition, six Republican governors have accepted the Medicaid expansion. He attributed this cooperation to Latino populations in southwestern states that rely on the federal grant program for assistance.

Michigan and Ohio have also signed on despite Republican representation. Thompson believes that the 10 most populous states in the nation, especially Georgia, Florida and Texas, will dictate the success of the program.

Students in attendance were curious about the sustainability of the program in the future. One member of the audience asked if shifting demographics, especially the population of aging baby boomers and potential inefficiencies made the program worth continuing.

“(In) cutting it, there really will be a price to pay,” Thompson responded.


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