Hours before the welfare vote, House Speaker Newt Gingrich proposed ending the federal entitlement status of Medicaid, the program that provides comprehensive health insurance for 36 million low-income Americans. At a New York press conference, Gingrich proposed funding Medicaid through block grants and insisted the plan would "deliver better care with better services at less cost." Unlike its higher-end cousin, Medicare, Medicaid already depends on vast state involvement, and the bill would likely fail without governors' support. "No one in Washington suggests block-granting Medicare," says TIME's Tumulty. "It would scare to many powerful constituencies. Medicaid, by contrast, has no powerful lobby."