Makes you wonder what the governors might be smoking

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John O'Connor
John O'Connor

What if your boss made the following offer: Many of the resources you need to do your job will be reduced or removed. But in exchange, you can play a more central role in making the cuts.

You'd have to be pretty naïve to welcome such an offer. Or a governor, apparently.

Because that is basically the Medicaid deal they received from President Trump at this week's National Governor's Association meeting. And from the looks of things, many of our states' top executives can't wait to try out this new “freedom.”

Now if you happen to be running a senior living organization that accepts Medicaid payments, this new arrangement might feel like less freedom and more like a pay cut. That's because, in effect, that's exactly what it promises to be.

But don't just blame Trump. In fact, the Republican governors' own Medicaid proposal serves up more of the same. Their blueprint would shift Medicaid from being an open-ended entitlement to a program each state designs within financial limits.

The new deal promises choice. But it takes away needed funds. Is that rationing? When you suddenly can't make payroll, does it matter?

By the way, I am not trying to gang up on the GOP. Democrats are equally capable of crackpot notions. It just so happens that this one might actually put your organization out of business.

So what's going on here? The conventional wisdom is that there is an urgent desire within the Republican Party to eviscerate all things connected with the former president. Probably safe to say a health law known colloquially as Obamacare would fit the bill.

But I think such a cynical assessment overlooks an obvious explanation.

You see, more states are decriminalizing the recreational use of marijuana. Among the drug's well-known possible side effects are hunger pangs and impaired judgment. According to people who track such things, record amounts of food were served at the latest NGA meeting. Draw your own conclusions.

John O'Connor is editorial director of McKnight's Senior Living. Email him at


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