I found it very odd in the debate last night that in talking about how he’d pay for a defense spending increase (along with his tax cut) Mitt Romney singled out his Medicaid block grant proposal, almost certainly the most shameful part of his domestic agenda, but one that not a lot of people understand. For a moment I hoped Obama would go into Medicaid in detail, but instead he chose to make another important point, the vast size of our current defense budget as compared to that of every other country on the face of the earth.

But today comes a report from WaPo’s Sarah Kliff on a new Kaiser Family Foundation study of the impact of a Medicaid block grant structured much as Romney (and House Republicans) have talked about.

The Kaiser report notes that the destruction of ObamaCare that Romney’s is proposing as the first act of his presidency would itself cut Medicaid enrollment by 17 million people. Add in the effects of the block grant, even if you accept Romney’s assumptions on the ability of states to reduce costs, and another 14 million are likely dropped from the Medicaid rolls (if costs stay roughly as they are now, it’s more like 20 million). And that’s in order to provide a small offset against spending increases beyond current Pentagon requests, and a tax cut for the wealthy that the wealthy don’t need (on top of continuing the Bush Era cuts forever).

Eliminating health insurance for somewhere between 31 and 37 million of the neediest Americans (totally aside from the other insurance-destroying features of Mitt’s fine health care thinking such as interstate sales and elimination of subsidies for employer coverage) isn’t “moderate.” Nor are the huge non-defense discretionary spending cuts (affecting education, transportation, environmental protection, and a vast array of other government functions) that Romney and Ryan both propose (though in a broad categorical, not an itemized, manner, so that supporters of any one type of spending can imagine it would be spared), which would also be made to help offset unasked-for defense spending and unnecessary tax cuts. The Moderate Mitt of the debate season has suggested he won’t let education cuts affect the number of teachers our schools employ, and he’s hinted the tax cuts might not be as large as he promised conservatives. But if you look at Medicaid, or at the many, many other programs–especially helping the poorest Americans–that are bound to be ground up in the bottom-to-top redistributionist scheme of the Romney and Ryan budgets, there’s no moderation there at all.

Ed Kilgore

Ed Kilgore is a political columnist for New York and managing editor at the Democratic Strategist website. He was a contributing writer at the Washington Monthly from January 2012 until November 2015, and was the principal contributor to the Political Animal blog.