President Donald Trump has rolled up his sleeves, and the federal government will never be the same again.

His pledge to transfer power out of Washington and to the American people is no idle campaign promise.  It is a sensible management solution to an unwieldy bureaucratic mess.  And if ever there were an unwieldy bureaucratic mess, it’s Medicaid – the most critical component of America’s safety net for needy mothers, children, the aged, blind, and disabled, which our recently departed president turned into the safety net for Obamacare.

Already providing inadequate protection because of pitiful physician reimbursement rates and verging on financial collapse because of garden-variety mismanagement, Medicaid under President Obama literally became the insurer of last resort.  By enticing the states to expand their Medicaid programs at no cost (for a while anyway) to working, able-bodied, childless adults, the feds exacerbated a budgetary crisis and endangered our highest moral obligation to protect access to medical care for the poorest among us.  The most fragile component of the nation’s social safety net was turned into a safety valve to cover 97% of the 9.25 million newly insured under Obamacare.

Ronald Reagan once observed that “the nearest thing to eternal life we will ever see on this earth is a government program.”  He understood the need to act, not just talk.  Soon after being elected governor of California, he found his state headed toward bankruptcy because of spending mandates from Washington.  The relatively new Great Society welfare programs were already exacting a toll – not just on taxpayers, but on the people they were designed to help: the vulnerable poor.

Gov. Reagan was the first state executive compelled to restrain runaway welfare spending.  He sought someone outside the system – a professional manager – to find a solution.  The man he chose, my husband, Bob Carleson, designed a reform package that resulted in shedding so many ineligible welfare recipients that enough money was saved to enable Gov. Reagan to grant a long overdue 25% increase in the basic benefit to California’s truly needy – following 12 years of “compassionate” Democrat rule.

The daily encounter with the bureaucratic impasse of Washington convinced Bob that the only way to protect both the poor and taxpayers was to get the overbearing federal bureaucrats out of the welfare business.  He devoted the rest of his life to doing just that.

Forty years after the launch of the Great Society, the planets and the electorate aligned to produce the revolutionary 1996 welfare reform – breaking the intergenerational cycle of poverty and freeing millions from government dependency.  Even the reluctant signer of the law, President Bill Clinton, couldn’t deny that repealing and replacing the iconic Aid to Families with Dependent Children program with finite block grants to the states worked.

Successful people like Mr. Trump like things that work.  They grasp the law of supply and demand, the reality of limited resources, the efficacy of incentives, and the benefits of competition.  They know that huge bureaucracies, whether governmental or corporate, work efficiently only when authority and responsibility are delegated wisely with real accountability.

Now, 20 years later, the proven 1996 reform model is part of President Trump’s plan to protect the intended beneficiaries of Medicaid – America’s most needy.  Rep. Todd Rokita (R-Ind.) has reintroduced legislation (H.R. 352) to repeal and replace the Medicaid program with stable funding and authority for governors in each state to determine the best way to safeguard the healthcare of their most vulnerable citizens.

Confident leadership and political popularity are often incompatible – especially in a city, where the most unnatural act imaginable is voluntary relinquishment of power.  But I trust that under President Trump, that won’t be the case for much longer.

Susan A. Carleson is chairman and CEO of the American Civil Rights Union (theacru.org).  She founded the Carleson Center for Welfare Reform in 2011 to continue the work of her husband Bob.