Republican Plan: Make Medicare more inefficient and expenses to prove it does not work well.

http://www.dailykos.com/story/2015/01/19/1358814/-How-Republicans-are-making-Medicaid-less-efficient-and-more-nbsp-expensive?detail=facebook

Medicaid is a lean, efficient, program and is in fact far less expensive than the rest of our healthcare system. It's also very popular with its customers, more so than private insurance is with people who have it. So clearly the job for Republicans is to fuck all that up, and they're doing it by adding layers of complexity and cost under Obamacare's Medicaid expansion program.
Take, for example, Arkansas—the state that got the ball rolling for red states seeking GOP twists on Medicaid expansion with its privatized version known as the "private option."Last month the state got approval for a byzantine new program, called Health Independence Accounts, that imposes co-pays on some beneficiaries unless they pay a small monthly fee. Those who have paid their fees are eligible, under certain conditions, for up to $200 to pay for the costs of private health insurance if their income goes up and they transition off of Medicaid. To run the program, the state will pay a third-party administrator about $15 million annually (covered by the feds as part of the cost of expansion).