Paul Ryan wants to take not only Medicaid, but programs for the poor in general (food stamps, disability insurance, etc) and put them into a block grant for the states. This means giving a fixed appropriation for the states, with no oversight, and gradually squeezing it down.
Unlike Medicaid, where I think there is a good chance of stopping him, I fully expect this one to pass without much difficulty. Squeezing the poor is always popular with Republicans, and with the broader general public.
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