In a recent article, I explained the ways in which the Obama administration has used blocks of federal money to implement progressive domestic policy: increasing the minimum wage and the earned-income tax credit program, supporting affordable housing programs and universal access to health care; and expanding the availability of Medicaid and Medicare.
A big piece of the puzzle here is the Affordable Care Act (ACA). This law not only allows millions of Americans to obtain health insurance coverage that complies with their own insurance needs, but it provides a robust welfare system to ensure that people who lack health insurance often have access to care.
The law provides a wide array of benefits that help to expand the health insurance coverage and health services available to low-income people, including, for example, subsidized co-pays, deductibles, and prescription savings accounts.
Why is it important for Congress to take action on block grants?
There are many reasons to vote in favor of block grants. For one thing, many politicians and pundits, and some in the press, argue that the federal government does too much. They claim that the federal government, without any meaningful role in determining the health care priorities of states, is overstepping its role.
These politicians and pundits often criticize the ACA for making too many federal mandates, such as requiring employer-provided health plans, or health insurance for people in the federal unemployment insurance program and Medicaid, which are not necessary unless there are enough jobs for everyone to obtain health coverage.
These politicians and pundits also frequently criticize the ACA for putting a bureaucratic burden on states, which they claim has been too great, to implement it. The ACA, they claim, has led states to do more with less, resulting in state-level costs and regulations that have burdened the federal government.
But this is simply untrue.
For one thing, federal spending on Medicaid has declined over the past 15 years, and states have cut government spending on welfare programs. For another, the ACA also provided tax credits that make available to low- and moderate-income Americans with modest incomes who do not have health insurance and who otherwise do not qualify for Medicaid.
Also, Congress has not acted to impose new burdensome regulations under the ACA. Rather, Congress has strengthened the Medicaid program, making it more likely for people to qualify for subsidies, and for states to spend health insurance money efficiently.
The ACA also made sure that insurance companies cannot be forced by states and businesses to cover a broad set of
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