- Ted, welcome back.

I wanted to talk with you about the uncertainty that's occurring right now with Medicaid, not only here in Rhode Island, but also at the national level.

I think when folks think about Medicaid, they think of a program that helps low-income individuals, and it certainly does, but it also helps many other groups of people.

- Yes, pregnant women and their children are often on Medicaid, especially in Rhode Island.

People on disabilities sometimes receive Medicaid services, senior citizens in nursing homes.

So lots of different groups, but it is targeted at people with lower incomes.

It also often gets confused with Medicare, which is the program for senior citizens.

Important for people to remember too, that those two programs are run differently.

So Medicare is fully a federal program, all run at the federal level.

Medicaid is run jointly by the feds and the states, and the states actually do the day-to-day management of the program.

- And Medicaid was expanded back in 2010 under the Affordable Care Act.

I don't know if people realize just how big the program has become in Rhode Island.

- Yes, I was looking at the governor's budget bill proposed for next year, and Michelle, the Medicaid budget is expected to total nearly $5 billion in Rhode Island next year.

- Wow.

- Put that in perspective, that's over one third of the entire state budget is now just the Medicaid program.

- And more than $3 billion of that total that you just mentioned for Medicaid is slated to come from the federal government, which brings us to what's happening in the news.

Republican leaders in Congress are currently working on a massive spending bill that would fund tax cuts, immigration enforcement, and other priorities of President Trump's administration.

And one way to fund that bill is to make cuts to Medicaid.

- Yes, and it does get a little arcane result, the congressional procedure going on here, but basically the House committee that oversees health programs has been tasked with finding $880 billion in spending cuts to help fund the bill you're talking about.

And there just appears to be no way to do that without significant reductions to Medicaid because President Trump has repeatedly taken off the table cuts to Medicare or social security, other big programs that they could have looked at.

And state leaders around are saying if there's any significant decrease in how much the federal government provides for Medicaid, there's just no way they could make up for that at the state level.

- We should point out, we don't know if Congress ultimately will make cuts to Medicaid, and if they do, just how severe those cuts will be.

- Yes, there's so much in flux right now, Michelle.

The House and the Senate in Washington are at odds over how that spending bill should look, what should be in it.

And also politically, people need to remember that Medicaid serves red states as well as blue states.

And that's why you're seeing some moderate Republicans express concern about the scale of potential Medicaid cuts we're talking about here, because it would hit their districts as well.

And so that's part of why it's just very unclear where this is going to go.

President Trump too, is a bit of a wild card.

He's at times suggested he didn't want cuts to Medicaid.

Other times sounded like he's on board with the House's plan.

So I think it could be months frankly before we know, really know where this is all going.

- And ultimately, both parties could be hurt by these cuts if it does happen?

- Absolutely, and that's what makes the politics of it so interesting and hard to predict.

- Always good to see you.

Thank you Ted.

- Good to be here.