It's often said that our federal system of government allows states wide latitude to experiment with ways to make government more efficient or just work better. There are numerous examples where pilot programs begun at the state level end up being adopted by Washington.
But such experimentation has never been tried on Medicaid reforms. Medicaid is run by the states but every state is reimbursed a certain amount by Washington for every program beneficiary. It's a program that cries out for drastic reforms.
The Medicaid program is racked with incompetence and corruption. Just last year, it was discovered in an audit that the state of Illinois spent $4.6 million on paying Medicaid benefits to dead people. Back in 2013, the state in another audit discovered that nearly half of all Medicaid beneficiaries enrolled were actually ineligible to receive benefits.
Now the Trump administration wants to reform Medicaid not be tweaking the program here and there, but by radical surgery.