It would convert Medicaid into a block-grant system, in a fashion similar to that of the spectacularly successful 1996 welfare reform law, giving states the flexibility to fashion programs that fit the needs of their residents.

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The House has called for a block-grant system that would allow states to use their federal education dollars as they see fit, as long as they sign pledges guaranteeing that state test scores will demonstrate a steady curve upward.

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Do you agree or disagree with converting the Medicaid program from the current system in which states and the federal government share oversight and funding responsibilities to a system of federal block grants to state governments, who would then decide how to allocate the grant funds to Medicaid recipients?

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Opening a Commons debate on the commission on 3 November 2011, Mrs Gillan told MPs she believed the current system - under which the Welsh government can only spend what it receives through an annual block grant from the UK Treasury - did not provide enough accountability for Assembly Members at Cardiff Bay.

BBC: Silk commission debate part one