As you know, Medicaid is the largest source of health coverage in the Nation. It provides coverage to millions of families with children, eight million people with disabilities, and it is the largest source of coverage for people needing long-term care. In other words, Medicaid provides health insurance to people who are uninsured or are uninsurable.

Medicaid serves as a vital healthcare safety net for the least advantaged of our citizens, particularly during times of massive lay-offs caused by a flawed trickle down economic plan. Is it without flaws? No. Are those flaws correctable? Yes. In fact, flaws in the program have been subject to bipartisan correction several times over the last twenty years.

Unfortunately, this Administration's irresponsible tax cuts and failed economic policies have led to fiscal crisis for the states, with great pressure on Medicaid. The Medicaid rolls have increased by about four million people since the Bush Administration took office. The response? Republicans are determined to substitute block grants for need-based Federal funding, thus putting the states at risk for rising Medicaid costs due to economic downturns or unforeseen cost increases.

A block grant may reduce some opportunities for gaming the system, but it will create others. Shelling out federal dollars with no accountability is not the answer. Moreover, the burden for caring for vulnerable American families would be shifted to the shoulders of the states and their residents. This at a time when they can least afford to handle additional responsibilities. It is unfortunate that fraud, waste, and abuse have now been enlisted to support the Republicans' desire to end Medicaid as we know it, and as millions of people have depended on it.