Here is a real-world follow up:
Suppose you have a state, like say, Texas, where there are some pockets of extreme poverty, and 60-70% of any given prac ioner's business *is* Medicaid? (known in Texas as STAR for adults, and CHIP for kids)
What if the reductions cause them to give up practicing altogether, or simply move somewhere else?
You then have reduced the ration of health care available in that area, and really ed over the county hospital, who is legally obligated to take anybody that walks into their emergency room. The county then is forced to raise whatever tax is available to it.
All such cuts do is simply shift more of the costs onto the people who can least afford it anyways, and very likely increase the costs to the system overall.
It amounts to a feel-good gimmick that not only doesn't solve a problem, it makes things markedly worse, IMO.
Not only that, but the Health Care Reform bill has cut a lot of federal funding that has, in the past, gone to border hospitals, and other county hospitals that serve poor areas, so those hospitals are going to get slammed already, and this would just make it worse.