Paul Ryan speaks on the federal budget, Capitol Hill, 2011. (AP Photo/J. Scott Applewhite)
The latest iteration of Paul Ryan’s budget is out today, and while you might expect it to look very different than the one proposed before he was part of a losing presidential ticket, he seems to have dug in his heels on some of his most extreme proposals, like block granting vital programs, voucherizing Medicare and drastically slashing spending. As with the first rounds of Ryan budgeting, this one would be bad for nearly everyone (except perhaps the wealthy), but it would especially take an enormous toll on the country’s women.
Women depend heavily on Medicaid. They make up 70 percent of its beneficiaries, which means 19 million low-income women have access to health care.
Last time around, Paul Ryan wanted to block grant Medicaid. This time is no different. In its current form, Medicaid is a program in which states and the federal government jointly finance health care for low-income people. Because the federal government shares the cost with states, it also requires them to adhere to some guidelines on benefits and eligibility. In a block grant system, however, the federal government sends a lump of cash off to the states with no strings attached. Even if actual spending on the program isn’t reduced (which, given the huge cuts to government spending included in this program, those who are wonkier than I may find it will be), simply changing the structure of the program this way is a very bad plan.
We’ve tried this experiment before: we block granted welfare, now called TANF, and it’s done a terrible job of helping low-income Americans, particularly as demand skyrocketed during the recession. In 2010, only twenty-seven of every hundred families living in poverty received TANF benefits. Some states could decide to increase benefits and eligibility, but given the tight budget constraints they face it’s much more likely that people will be dropped. In fact, somewhere between 14 million and 27 million could lose Medicaid coverage by 2021 under a block grant system. That will have a huge impact on the women who rely on it.
But the picture gets even worse when you consider what else he wants to do.
Ryan also promises to repeal the Affordable Care Act. While he doesn’t want to repeal cuts to Medicare spending included in the act, he does promise to repeal the benefits, perhaps the biggest of which is the Medicaid expansion. Women would reap huge benefits from the expansion of Medicaid, given that 13.5 million were expected to get health coverage that way by 2016.