Countless pages of news sites have been dedicated to the analysis of President Trump's surprise election loss against Joe Biden. While much of the attention has been focused on allegations of election fraud and ways that it may have swung an excruciatingly narrow margin in several key states in favor of the Democratic nominee, a relatively obscure piece of healthcare policy may have also played a role in this unexpected upset.
Most Americans have very little love lost for unelected bureaucrats in Washington, and by pushing counterproductive rules insensitive to rural America's needs they may have very well cost Trump the presidential election.
The exit polls in battleground states like Georgia, Pennsylvania, Wisconsin and Arizona tell the story well. Healthcare was a top 5 issue in all of these states, and Trump ultimately lost that issue by 81-18%, 84-15%, 81-19%, and 78-20%, margins in those areas, respectively.
Now, after taking a brief election season reprieve, these academics and healthcare "experts" appear to be back at it, pushing the same kinds of new mandates that may have very well cost Republicans the White House.
Take, for example, a former special assistant to the president's National Economic Council who now appears to be suggesting that Centers for Medicare and Medicaid Services (CMS) once again start the process of finalizing the misnamed Medicaid Fiscal Accountability Regulation (MFAR). This regulation pinned the administration against doctors, hospitals and the political grassroots during the campaign.
Seema Verma, who administers CMS, created MFAR for the stated purpose of bringing more accountability to Medicaid. However, critics quickly pointed out that the rule looked a lot more like a bureaucratic power grab than it did a limited government reform measure.
To prevent states from supposedly abusing the Medicaid funds they receive from the federal government, CMS proposed giving the federal government the right to veto their funding mechanisms and budgets outright. This would fly in the face of the very principles of states' rights and federalism that Republicans and conservatives hold so dear.
A better way to cut back on federal funds would be block-granting — the practice of giving states a set funding allocation from the federal government each year and letting them use the money how they see fit. That may be an insensitive thing to do during a pandemic, but it is still better than the alternative of going full big government and dictating to the states what they can and can't do with their own funds — like some are proposing.
While this rule didn't go over well anywhere the first time it was proposed, rural areas, which use Medicaid disproportionately more than the rest of the country, would have felt the pain more than most.
As the Washington Examiner made clear, hospitals in rural areas' "operating margins are significantly lower than the rest of the country" and many of their health care facilities "are already at a significant risk of closure, with a whopping 172 closing over the last 15 years." One rural hospital provider event went so far as to say that MFAR "just being proposed has made it difficult to impossible to responsibly plan for proper patient care."
So residents of these areas have every reason to worry over MFAR's implementation.
Over time, the Trump administration understood this lesson the hard way. Shortly after the Biden campaign began weaponizing Verma's MFAR against them, and after Team Trump faced mounting headlines like "Making a Bigger Mess of Medicaid" and "Looming federal regulation a nightmare for rural states and healthcare" in traditionally conservative outlets, the Republican White House cried uncle.
Verma suspended her intended implementation of the proposed MFAR rule in September, but by that point, the damage was already done to the president's healthcare reputation.
Fast forward to the present, and now some in Washington want the White House to restart the process of implementing this disastrous rule before the Biden camp takes over. This should not be the final word on what has been an otherwise mostly successful healthcare agenda from President Trump over the last four years.
The Trump administration started as the White House for forgotten America. It should end that way, too. Let's keep MFAR dead and put the interests of people before politics.
Travis Korson is a veteran of politics with years of experience in campaigns, communications, and public policy. He previously served in the Bush White House and has also spent time at various conservative organizations and government institutions including the Heritage Foundation, Americans for Prosperity, and the Faith and Freedom Coalition. He is a graduate of the George Washington University where he studied International Affairs with a focus on International Economics. Read Travis Korson's Reports — More Here.
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