Medicaid operates under a 1960s model of medicine, with inflexible, one-size-fits-all benefits and little consumer engagement and responsibility. Expanding the entitlement program as it stands would further cement a separate and unequal tier of health coverage. Without fundamental reform, Medicaid will continue to deliver what it has for decades: limited access, poor quality and budget deficits. …

A number of Republican governors have asked to meet with President Obama to discuss their solutions, but the White House has ignored these requests. The president claims that he wants to work across party lines to get things done for the American people, so perhaps he could start by meeting with Republican governors who want to solve our nation’s health-care problems.

Our ideas to fix Medicaid target several areas for reform: eligibility, benefit design, cost-sharing, use of the private insurance market, financing and accountability.

First, the process to determine eligibility should be simple, accurate and fair. There are far too many complicated categories of Medicaid eligibility. The process should be easier for consumers to navigate and for states to administer. States should have the flexibility to set eligibility standards that make sense for residents, instead of the rigid, one-size-fits-all approach dictated by Washington. …