Viewpoints: Does the GOP plan fix a 'broken' Medicaid system or harm it?; Romney's confusion on abortion

The Wall Street Journal: Medicaid Is Broken – Let The States Fix It
Medicaid, America's safety-net program for more than 62 million low-income uninsured Americans, is broken. ... The best hope for Medicaid reforms that can improve care for low-income enrollees, reduce fraud, and put the program on a sustainable trajectory is to cap federal spending to the states by using block grants. Block grants would offer states a predictable source of federal funding in return for broad state flexibility in Medicaid administration, benefits and copays (Paul Howard and Russell Sykes, 10/10). 

Roll Call: Trying To Make The Math Add Up On Medicaid
Finding ways to restrain future growth in health care spending is an urgent priority. But Medicaid is already far more efficient than private health programs or Medicare, in large part because reimbursement rates to providers are ridiculously low. Cutting rates to providers would be counterproductive, and needs under the program, especially for the most sick among us, are likely to grow. Repealing the health care overhaul and making Medicaid a block grant are, at best, inadequate responses (Norman Ornstein, 10/11).

The New York Times: The Wrong Way To Help The Poor 
Most Americans understand that people enter poverty for many reasons and that we have an obligation to help them get out of it. A "conservative" path of just slashing budgets isn't going to meet that obligation, but neither is the "liberal" path of embracing every program and spending more on each. We need a third way. The changes to spending on human services and Medicaid in Mr. Ryan's budget proposal, if not a perfect template, could be a catalyst for starting the conversation. If only it would come up at tonight's debate (Gary E. MacDougal, 10/10). 

The Boston Globe: A Health Care Disaster
I have had the privilege of interviewing both President Obama and former Massachusetts Governor Mitt Romney about health care reform. ... I found the two key elements in each of their plans -; mandated insurance and insurance exchanges to make choices easier -; to be almost identical in concept. ... We in Massachusetts are fortunate to have political, insurance, and medical leaders who are committed to quality and cost control. But that is not true in many other states. And simply letting each state design its own system would be a disaster: 50 legislatures subject to the pleadings of industry lobbyists, with the lives of patients potentially at risk as a result (Dr. Tim Johnson, 10/10).

New England Journal of Medicine: Health Care Policy Under President Romney 
His fundamental policy proposal is to undo the ACA, the nation's most consequential health care reform law. His replacement proposals would provide no meaningful security to people who would lose the law's coverage protections. His Medicare and Medicaid proposals would irrevocably transform these programs. His budget and tax proposals would threaten the country's basic health infrastructure as few in living memory have done. One can only hope that if elected President, Romney would surprise the United States as he did Massachusetts (Dr. Eli Y. Adashi, John E. McDonough and Kartik K. Venkatesh, 10/10). 

New England Journal of Medicine: The Shortfalls of "Obamacare"
What is needed are reforms that create clear financial incentives that promote value over volume, with active engagement by both consumers and the health care sector. Market-friendly reforms require empowering individuals, armed with good information and nondistorting subsidies, to choose the type of Medicare delivery system they want. ... If market-friendly Medicare reform is your aim, a good place to look is the plan proposed by Senator Ron Wyden (D-OR) and Representative (and vice-presidential candidate) Paul Ryan (R-WI) -; not the ACA (Gail R. Wilensky, 10/10).

The New York Times' Taking Note: Romney's Confusing Abortion Comment
Yesterday, Mitt Romney told the editorial board of the Des Moines Register: "There's no legislation with regards to abortion that I'm familiar with that would become part of my agenda." It sounded like Mr. Romney was trying to distance himself from the anti-abortion position he took during the primaries. … Andrea Saul, a spokeswoman for Mr. Romney, later told the National Review Online that "Governor Romney would of course support legislation aimed at providing greater protections for life" (Andrew Rosenthal, 10/10).

Slate: Romney's Abortion 'Agenda'
If you want to understand what will happen to the no-legislation assurance Romney gave to the Register yesterday, look at what happened to the assurances he gave to voters in Massachusetts a decade ago. In 2002, as a candidate for governor, he repeatedly promised to "preserve and protect a woman's right to choose." After he was elected, he reinterpreted that statement as a pledge not to "change our abortion laws either to restrict abortion or to facilitate it." This allowed him to veto pro-choice legislation. Then, as he moved on from Massachusetts and began to court pro-lifers as a presidential candidate, he reinterpreted his no-change policy this way: "Every time I faced a decision as governor that related to life, I came down on the side of life" (William Saletan, 10/10).