"So, the health care entitlements are the big, big, big drivers of our
debt. There are three. Obamacare, Medicaid, and Medicare. Two out of
three are going through Congress right now. So, Medicaid—sending it back
to the states, capping its growth rate. We’ve been dreaming of this
since you and I were drinking out of a keg."
http://www.slate.com/blogs/the_slatest/2017/03/17/paul_ryan_s_college_dream_was_to_kick_poor_people_off_medicaid.html
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