A lot of states are swamped in deficit and debt thanks to high unemployment. With a lot less people working and paying taxes as we had four years ago. And instead of working and paying taxes, they are instead consuming more public services. Paid for by less tax revenue, California being a perfect example of this. Medicaid was already set up in the 1960s as an unfunded mandate that has to come out of general revenue.
Unfunded mandates makes it even harder to pay for Medicaid. And when we have less people working and more poor people in the country Medicaid or Medi-Cal as its called in California becomes even harder to pay for, especially with the Federal Government Continuing to pass down regulations without the funds to pay for them. The way to fix Medicaid not just for California, but every other state, there are a few of ways.
One let each State have Medicaid to run. Each State would have its own version of Medicaid. Which would help make Medicaid self-financed, that would be paid for by its consumers and their employees. Unemployed workers would get a tax credit provided by the Federal Government to cover their health care costs and employers would get a tax credit from the Feds to cover their Medicaid costs.
Two instead of even having the states run Medicaid, convert each Medicaid into a semi-private non-profit self-financed health insurer that provides health insurance for low-income people. And let the States, Feds and locals regulate these health insurers instead.
Medicaid wasn’t set up to be efficient or cost-effective. But to provide health insurance for people who couldn’t get it any other way. Which it has done for the most part, but it needs to be reformed. To make it cost-effective, especially when budgets are tight for everyone.