The Next Priority for Health Care: Federalize Medicaid

Medicaid has always been plagued by inequities and inefficiencies due to its dual federal-state character, which diffuses accountability, and because some state governments simply don’t care much about the poor.

One of the fundamental reforms in this year’s Patient Protection and Affordable Care Act is its commitment to enroll in Medicaid all non-elderly Americans with incomes up to 133 percent of the poverty line. The new law takes important steps toward moving Medicaid down a path toward full nationalization, with the federal government bearing 96 percent of the cost of the program’s expansion over the next 10 years.

In a controversial and groundbreaking new policy paper for the Next Social Contract Initiative and The Century Foundation, Greg Anrig argues that the next major medical care reforms should fully federalize Medicaid, which would relieve states’ financial burdens and enhance the health of the American population.

Read the full policy paper here.

Greg Anrig, vice president of policy and programs at The Century Foundation, is the author of The Conservatives Have No Clothes: Why Right-Wing Ideas Keep Failing.




Greg Anrig is a senior fellow at The Century Foundation and the author of Beyond the Education Wars: Evidence that Collaboration builds Effective Schools.