In an event at The Heritage Foundation last week, Senator Orrin Hatch (R-UT) outlined his comprehensive plan to reform Medicaid, one of the three big programs driving America’s spending problem.

Medicaid,  Hatch explained, was originally designed to provide a safety net for the poor, but it is now an entitlement cushion for a quarter of the American population.  The program, he said, is a “massive target for waste, fraud, and abuse.” And it is no longer fulfilling its own objectives.

So, what positive change is needed to make this system functional? State flexibility.

Hatch explained that there is clear evidence that the states know best what kind of health care their residents need. Governors and state legislators understand the needs, culture and values of their respective states. And yet, the federal government continues to micromanage health care – even requiring states to ask permission before making small adjustments.  

The goal of any Medicaid reforms should be two-fold: save money and improve care for patients. Some states have already begun innovative solutions that are positioning them to take the lead on improving healthcare. Why not allow other states to pursue their own paths to success?

The critical flaw of Medicaid is that it treats people who are poor as though they are incapable of taking care of themselves. Hatch is determined to get the program back on track and promote personal responsibility for future generations.

Heritage’s Brian Blase pointed out last month that Medicaid spending is spiraling out of control and imposing crushing burdens on the states. Read all Heritage research on Medicaid on

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