On why have Republicans wanted to overhaul Medicaid
“Well [the Republicans’] argument is that the Medicaid program is extremely inefficient, that it requires things that are not productive to health. There should be more opportunity for state innovation, and in particular they go back to the argument that in 1965 when the Medicaid program was enacted along with Medicare. It was intended for very poor people who simply had no means of their own to provide for their care. They argue now, particularly under the Affordable Care Act and the Medicaid expansion, that health care coverage paid for by the taxpayer is going to a lot of people who should be able to take care of themselves on their own.”