Republican U.S. Senator Lamar Alexander is proposing a "grand swap" in which the federal government would take over all responsibility for Medicaid and the states would gain all control over education.
The senator said in an address to a joint session of the Tennessee General Assembly on Wednesday that the proposal mirrors one he made to President Ronald Reagan three decades ago while Alexander was Tennessee governor. Alexander said Reagan embraced the idea, but it did not gain any traction in Congress.
Alexander told reporters after the speech that he see similar barriers to his proposal amid Democratic control of the Senate and the presidency, but said the change would remove the concerns and political challenges facing the states on expanding Medicaid or creating state insurance exchanges.