Republicans' New Plan to Gut Public Insurance

Medicaid has essentially functioned the same way for half a century. Eligibility for the program has changed, most notably when Obamacare extended an option to states to expand coverage to all low-income adults. But once they are enrolled, beneficiaries are entitled to guaranteed coverage, with their home states and the federal government splitting costs with no upper limit. This open-ended, shared funding structure is vital for covering the kinds of people Medicaid tends to cover. Almost two-thirds of Medicaid costs come from low-income elderly and disabled people with serious—and thus expensive—health-care needs.

Republicans have long hankered to change that structure to cut costs to the federal government, and a new plan from House GOP leadership shows