PolicyGuy

Tuesday, December 20, 2005


Sunbelt Revolution in Medicaid.
First the people went to the sunbelt. Then the political power. Now, the political innovations.

Florida and South Carolina are leaders in reforming Medicaid, the program that threatens to eat the budgets of every state. Nina Owcharenko writes that "Florida and South Carolina are pursuing federal waivers so that they can bring the principles of choice, individual control, and competition into Medicaid."

Why these states? Among other reasons, they attract a large number of retirees, who often end up in nursing homes, in Medicaid, and that program's most costly recipients of taxpayer money. Most of the money-saving efforts work best outside the nursing home environment, but even those can free up money for other purposes.

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"Justice Louis D. Brandeis'?s metaphor of the states as "laboratories" for policy experiments ... had almost nothing to do with federalism and everything to do with his commitment to scientific socialism. .... To this day, it continues to inhibit a truly experimental, federalist politics." -- Michael S. Greve

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