Medicaid is a joint federal-state program that provides medical care to nearly 70 million low-income individuals nationwide. It is a means-tested program that is managed by the states. People served by Medicaid are U.S. citizens or legal permanent residents, including low-income adults, their children, and people with certain disabilities. Medicaid has expanded rapidly since its inception in 1965. This could possibly be linked to the program's financial structure, in which the federal government matches state spending. The incentives are so dysfunctional that states have inflated the cost of health care. • State expenditures on Medicaid have increased from 0.2 percent of tax revenues in 1966 to an estimated 21 percent in 2005. • In 1975, 10 percent of the U.S. population was enrolled in Medicaid, by 2008, 19 percent were enrolled. • In FY 2010, Medicaid surpassed elementary and secondary education as the largest component of total state spending. • ObamaCare will add 18 million people to Medicaid rolls. Even without reform, Medicaid spending may increase by as much as 50 percent in 10 years. This is an unsustainable model. State-by-State Insurance Information is available at this site.

Charity Without the Welfare State

from Goodman Institute,
One of the big sticking points in the debt limit discussions between President Biden and the House Republicans was whether there should be a small increase in work requirements for people receiving entitlement benefits. In the end, the negotiators basically punted on what is probably the most important public policy issue the nation faces: Who should get free food, housing, medical care and other benefits, and what—if any—should the conditions be? The current system is having a devastating effect on self-sufficiency, family formation and marriage. A better alternative is within our grasp. Let’s start with the harm our system is doing.
  • Penalties for working.
  • The marriage tax.
In search of alternatives.
  • Give food stamps, Medicaid, housing subsidies, earned income tax credits, and so forth, to everyone, and don’t reduce them with income.”
  • If instead of Medicaid, we simply designated certain hospitals and clinics as “safety net institutions” and made care available regardless of income, we could probably provide more care to more needy patients than we do now and avoid the costs of an enormous amount of bureaucratic paperwork in the process.
Conclusion. We can have a safety net that meets the needs of people who experience misfortune without creating a permanent class of nonworking dependents who behave in socially undesirable ways. More From Goodman Institute:  

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