The program’s funding mechanism lends itself to bloat and inefficiency. The Senate can set this right.
National health-insurance coverage has been a top priority for the American left for decades. Medicaid has been the main vehicle for reaching this goal since 1965. The program now accounts for more than half of the 150 million Americans covered by government health insurance. President Trump’s “big, beautiful bill” presents the Senate with a choice: Continue on the path toward national health insurance by locking in recent Medicaid expansions, or reform Medicaid and reverse course.
After the defeat of President Harry Truman’s national health-insurance plan in 1949, Democrats began an incremental journey. Medicare for seniors and Medicaid mainly for state welfare recipients were their first major steps. After Medicare was extended to the disabled in 1972, Democrats turned their attention to expanding Medicaid.
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