In January 2020, President Trump gave states the ability to turn Medicaid into block grants. Medicaid is a public health insurance entitlement program. It is a guaranteed contract between the government and its people. The program provides health care coverage to low-income families or individuals. It covers doctor visits, hospital stays, long-term medical care, custodial care, and other health-related costs. It is an obligation. If you meet the criteria, by law you have to be let into the program and your needs must be covered.
Entitlement is a legal term
A block grant is not a contract. It is a grant. Grants are not obligations or contracts. It is a program restricted by budget and individuals may be covered depending on if there is money available. Who is covered is at the discretion of the person administering the grant.
A month after that pronouncement, Trump tells Bob Woodard regarding COVID-19, “You just breathe the air and that’s how it passes. It’s more deadly than your, even your strenuous flu.”
Entitlement is a contract between a country and its citizens
This makes Trump’s timing of turning Medicaid into block grants especially heinous. He was made aware of what was coming with COVID-19, from his February interview with Woodard he seemed to understand the potential severity of what was coming, and yet he implements a program that could potentially limit Medicaid funding and access.
“The [block grant] program — branded as the ‘Healthy Adult Opportunity’ — will allow states to ask permission to end their traditional, open-ended Medicaid program and put hard caps on how much money states and the federal government will spend on the poor and disabled.”The Hill
The Healthy Adult Opportunity, in a nutshell, allows less paperwork for easier upfront money for Medicaid like services and more autonomy (easier to be racist, sexist, and biased) in exchange for killing people by denying them service and sending them through a paperwork maze of hell.
Entitlement is the name of the type of contract and that is what it is referred to in the English speaking world
Medicaid is a federal entitlement program. Turning any portion of an entitlement program into a block grant destroys the program. Don’t let the term entitlement wrinkle your nose. Entitlement is just a funding designation for a Federal program.
Entitlement is a federal program or provision of law that requires payments to any person that meets the eligibility criteria established by policy. Entitlements are a legally binding obligation between the Federal Government and the eligible person. If not fulfilled, the recipients have legal recourse. Entitlement programs began broadly in 1935 under Roosevelt to alleviate people’s suffering owing to the Great Depression, but they existed before in the 1900s under the Mother’s Pension program.
A program that is an entitlement program if you are not provided with the program benefit you are eligible for, you can receive legal recourse
In addition to Medicaid — Social Security, veterans’ compensation, and pensions are examples of entitlement programs.
Entitlement programs are the most accessible of social support programs in the United States. The funding covers everyone who is eligible, and agencies can adjust the budget depending on the need.
For instance, say we were in a pandemic, and people eligible for Medicaid needed more help. It would be easier to get them help because there are no limits on entitlement programs, and it is flexible. It helps anyone who meets the criteria.
In the US entitlement programs were predominantly a white only benefit
The wealthy do not like entitlement programs. People who are at peace are harder to exploit. And paying their fair share might require them to pay a few more pennies in taxes than they already do not pay.
The wealthy have moralized poverty, disabilities, and race to deny access to those groups to America’s table. Wealthy people did this all so they can have a hungrier workforce and pay fewer taxes.
After the passage of the 1964 Civil Rights Act the r(igh)acist birthed block grants to do away with the guarantee portion
One way they have done this is by introducing a new solution to fund social service programs. Their answer is block grants. Block grants are fixed pots of money that the federal government gives to states to provide benefits or services. It effectively breaks both the figurative social contract and the literal contract of entitlement funded programs.
It also allows states the flexibility to try to institute punitive work requirements.
Trump waving the carrot of a state turning a port of the Medicaid to block grant funding allows the states to share the burden of his shame in killing people.
“The problem with ‘Block grants’ is that the funding levels tend to fall short of financial need.’ The consequence is that the programs face “benefit cuts, eligibility restrictions, or waiting lists. Funding levels are often inadequate initially and typically erode over time.” — Center for Budget Priorities.
For the people who ask, how do we pay for this? We could cut the approximately $600 billion military budget in half or make the rich pay their fair share in taxes.
In Brookings’ Batchelder and David Kamin (2019), using JCT projections (2016), estimate that taxing accrued gains at death, and raising the capital gains tax rate to 28 percent would bring in $290 billion between 2021 and 2030. In the 90s, this was approximately the tax rate.
Even without that, they have the money. The feds in the last 12 months poured $10 trillion into Wall Street. The money is there.
But you know how can we afford to not pay for health care for our citizens? Look at what not paying and breaking the social contract with our citizens has done to our country during COVID-19? Over 208,000 people died, small businesses shuttering, and layoffs in the hotel, airline, and restaurant business.
All of this, because rich people, like Trump, don’t want to pay their taxes.