Health Care, Medicare, and Medicaid Questions:
Q: Doesn’t your plan simply dismantle Medicare and Medicaid as entitlments and put health care at risk for millions of poor people and the elderly who depend on it?
A: I want to be clear: my proposal does not end Medicare and Medicaid. In fact, it brings these programs that were created in the 20th-century in line with the realities of the 21st-century. Furthermore, it strengthens the safety net that people enrolled in these programs rely on. This plan ensures Medicare beneficiaries who are counting on receiving a benefit actually have one – by making all beneficiaries eligible for an income-related payment. Low-income beneficiaries get higher payments and fully funded medical savings accounts to cover out-of-pocket medical costs. In addition, the payment is risk-adjusted, so those with greater health needs receive additional assistance. 

The bill also modernizes Medicaid by giving states maximum flexibility to tailor their Medicaid programs to the specific needs of their populations. It allows Medicaid recipients to avail themselves of the health-coverage options open to everyone else through a tax-credit option. For States that want to continue their Medicaid programs as currently structured, they may do so under my plan. The only change would be that federal matching funds would distributed in the form of a block grant and increased every year in a way that would help restrain overall health care spending.