As a state under annual threat of budget deficits that also has the country’s highest Medicaid cost per enrollee, Rhode Island can’t afford not to think about reforming the public health care program.

In the waning days of the presidency of George W. Bush and the governorship of Republican Donald Carcieri, the state experimented with a nation-leading“global waiver” to lower costs in exchange for flexibility.

Even though the experiment was largely successful, intervening governors and the federal Affordable Care Act (ACA; ObamaCare) appear to have blocked parts of the reform and let others peter out.

Now, progressive Democrat Governor Gina Raimondo has convened a Working Group to Reinvent Medicaid, with a collection of reforms of her own, designed to save or raise $91.1 million in state money next year–a little less than 10 percent of the state’s total Medicaid spending.

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