It’s a vision that says up to 50 million Americans have to lose their health insurance in order for us to reduce the deficit. Who are these 50 million Americans? Many are somebody’s grandparents -- may be one of yours -- who wouldn’t be able to afford nursing home care without Medicaid. Many are poor children. Some are middle-class families who have children with autism or Down’s syndrome. Some of these kids with disabilities are -- the disabilities are so severe that they require 24-hour care. These are the Americans we’d be telling to fend for themselves.
It’s anyone’s guess as to how states would react in 10 years to Ryan’s proposal. The same goes for how states will cope with rising health costs. The administration’s 15 million figure is speculation, and so are Obama’s claims that "poor children," "children with autism" or "kids with disabilities" would be left "to fend for themselves." The Ryan plan in no way says that states don’t have to cover such individuals. Instead it says that states would have "freedom and flexibility to tailor a Medicaid program that fits the needs of their unique populations."