In "Million Dollar Baby," Hilary Swank's character offers her mother a free house. But the mother angrily rejects the offer, requesting cash under the table instead. The reason: a house would disqualify her for welfare and Medicaid benefits.

Reform of at least one of those problems is well under way, thanks to Pete du Pont and then Bill Clinton and then (mostly Republican) members of Congress - all of whom promised to "end welfare as we know it." What is now needed is to end Medicaid as we know it.

Imagine that tomorrow's newspaper carries the headline: "Supreme Court Declares Medicaid nconstitutional." After much hand wringing, Congress would almost certainly give the Medicaid funds to the states as an unrestricted cash grant and hope for the best. We would then get 50 different experiments - almost all of which would significantly improve the current system.

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The NCPA's Medicaid Reform Service Center is designed to provide assistance to state think tanks, governors, legislatures, and other groups seriously interested in Medicaid reform. We will provide speakers, briefings, testimony, help with publications, help with the design of reforms and, in some cases, help with federal waivers. We will pay some (but not all) of the costs for these efforts. The degree of help the NCPA offers depends on prospects for reform in the states that request our help. NCPA economists participating in this effort helped design Medicaid reform plans in South Carolina and Florida, and are currently involved in reform efforts in Massachusetts, New York and Kansas. You can read a more detailed description of the program here.