Want to reform Medicaid? Accountability is the way forward
Government works best when its rules reward responsibility rather than dependency
Thirty years ago this summer, Congress passed the Personal Responsibility and Work Opportunity Reconciliation Act. Welfare reform succeeded because it recognized a simple but powerful truth: public programs work best when they reward responsibility, accountability and innovation.
States make better decisions when they have both authority and responsibility for the results. By giving governors greater flexibility while also making them more accountable for the outcomes, we encouraged states to rethink old assumptions, experiment with new approaches and become better stewards of taxpayer dollars. Good intentions alone do not produce good government. Incentives matter.
That lesson is just as relevant today.
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