Let's start with Medicaid, a health insurance program meant to benefit the poorest US residents. After passage of the Affordable Care Act, 31 states and the District of Columbia expanded Medicaid eligibility -- some locales allowed people with incomes up to 200 percent of the federal poverty guidelines to gain access to coverage. This has provided health insurance to 20 million previously uninsured people, including many children, and increased the total number of people on Medicaid to 74 million. Newly installed head of Health and Human Services, Tom Price, has proposed rescinding their coverage by repealing the ACA, a move that will save the feds an estimated $500 billion a year. In its place, Price wants Medicaid to become part of a block grant program, a proposal that advocates for seniors and people with disabilities say will be a disaster. David Certner, legislative counsel to AARP, notes that block grants are typically small, so that in the event of an economic downturn or emergency health crisis, states will be left scrambling for revenue to fund necessary services.
Max Richtman, CEO and president of the National Committee to Preserve Social Security and Medicare, notes that it's not a coincidence that the Trump administration has targeted Medicaid first, since most recipients are youth or people with low incomes. "There is not a strong constituency protecting it," he says.