A debate has arisen among conservatives over how much freedom the states should have. Some argue for a "no-strings-attached" approach under which federal requirements on state use of block grant funds would be minimal. Others want the federal govermnet to impose what they see as a conservative version of welfare, replacing the current liberal one.
One of the biggest problems facing workers in job transition is that health insurance is not "portable." Although the average person will change jobs eight times during his working life, employees are limited in their ability to keep their health insurance during job changes and periods of unemployment.
The political situation has changed since the ESA was first passed. As was true more than 20 years ago, the debate is being driven by a nationwide grassroots movement. However, this time the coalition is composed of small property owners and property rights advocates rather than animal rights groups or public land advocates. With the new Republican majority in Congress, they have found a receptive audience.
As currently structured, Medicare pays many small bills which the elderly could easily afford and does not pay the catastrophic expenses that could devastate them financially. Medicare is in need of serious reform.