Two months ago in July, a Republican Congress and administration had a chance to reform our nation’s low-income health care program, Medicaid, but fumbled the ball in their inability to agree on the larger goals of health care reform.

Congressional leaders may want to leave the wreckage of this year’s health care reform debacle behind them as they move on to other issues, but the latest Census Bureau report on poverty and health insurance is a good reminder of why Medicaid reform should still be a priority. Legislators may well want to look at individual states again for possible solutions.

Going forward, lawmakers in Washington should revisit the welfare reform playbook as they think about Medicaid reform. This could start by studying state-level reforms. The 1981 law allowing states to apply for exemptions from federal welfare law required an evaluation of the welfare experiments conducted by states. Collectively, the assessments provided evidence that work-based welfare was better than cash assistance alone...

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