Despite Democrats’ repeated calls for decades to rid Medicaid of waste, fraud, and abuse, now that Republicans are poised to deliver major Medicaid reform those same Democrats are crying foul.
House Republicans have unveiled portions of President Donald Trump’s “big, beautiful bill,” that would, along with extending the Trump tax cuts, slash government spending by attempting to root out “waste, fraud, and abuse” in Medicaid.
“Savings like these allow us to use this bill to renew the Trump tax cuts and keep Republicans’ promise to hardworking middle-class families,” House Energy and Commerce Committee Chairman Brett Guthrie (R-KY) said.
The reforms would include “community engagement requirements” of at least 80 hours per month, which includes work, education, or service for able-bodied adults without dependents. It would also mandate that those on the program would have to verify eligibility to be in the program twice per year instead of the standard one time per year.
Democrats have said that the proposed cuts are “shameful” and claim that the reforms amount to another attempt to repeal Obamacare, more formally known as the Affordable Care Act (ACA).
“In no uncertain terms, millions of Americans will lose their health care coverage,” Rep. Frank Pallone (D-NJ), the top Democrat on the Energy and Commerce Committee, remarked.
He then claimed that “hospitals will close, seniors will not be able to access the care they need, and premiums will rise for millions of people if this bill passes.”
Even though Democrats have cried foul over Republicans’ reforms, former Democrat presidents and Democrat congressional leaders have repeatedly called to remove waste, fraud, and abuse from the program.
Sen. Chuck Schumer (D-NY) asked rhetorically in 2010 at then-President Barack Obama’s healthcare summit:
And the real nub of this is how do we wring that waste out, that fraud, abuse, duplication [emphasis added], without interfering with the good care that we want every person on Medicare, Medicaid, and private insurance to get. The average citizen knows this happens. How many times, when you look at your medical bill, you’ve undergone a minor procedure, and you see Dr. Smith, $4,000, and you sort of vaguely remember he just waved and poked his head in the door?
In October 2012, Schumer even suggested that Republicans would receive Medicare and Medicaid reform as part of a grand bipartisan bargain.
In 2012, Sen. Dick Durbin (D-IL) appeared to suggested that Medicaid reform is bipartisan:
“A bit of a charade,” as Senate Majority Whip Richard J. Durbin (D-Ill.) described it Tuesday.
As Mr. Durbin’s remark suggests, reform is a bipartisan idea. President Obama’s last budget would have reduced the maximum permissible provider tax to 3.5 percent, saving $21.8 billion over 10 years. A deficit plan by Sen. Bob Corker (R-Tenn.) includes a 10-year phaseout, at a projected savings of $50 billion.
Then-Vice President Joe Biden in 2011 even lamented how states use accounting gimmicks to artificially boost their federal Medicaid reimbursements, especially in provider taxes:
It’s a scam, Biden agreed. The states were gaming the system, taxing doctors and hospitals so they could get federal reimbursements and then returning the money to the providers. Let’s call it like it is, and let’s just do this. . .It could save $40 billion. “If we can’t do this —” the vice president said, “come on!”
Indeed, this appears, to be borne out by a study by the Paragon Health Institute and the Economic Policy Innovation Center (EPIC), which found that Medicaid doled out $1.1 trillion in improper payments over the last decade:
In only two out of the past 10 years did audits by the Centers for Medicare and Medicaid Services (CMS) assess the accuracy and completeness of state eligibility reviews. In those two years that did include meaningful, complete audits of state Medicaid programs, improper payment rates exceeded 25 percent. Applying a 25 percent improper payment rate across the $4.3 trillion of federal Medicaid spending between 2015 and 2024 yields roughly $1.1 trillion in federal Medicaid improper payments over the past decade [emphasis added].
Hospitals are also permitted to enroll patients into Medicaid based on a few questions about income and household size, often receiving temporary Medicaid coverage with little to no verification.
“The Foundation for Government Accountability found that in 2018, 70 percent of people deemed eligible by hospitals were eventually determined ineligible or did not ultimately have their information verified,” the authors stated.
Rep. Scott Perry (R-PA), the former Freedom Caucus chairman, has made this argument, saying in March, “On Medicare and Medicaid, the president has said we’re not going to touch those programs from a beneficiary stand point, but what he’s never said is we’re not willing to touch those programs from a fraud standpoint,” which he said includes improper payments or payments to illegal aliens.
EPIC and the Paragon Institute in their paper called for more frequent reviews of eligibility and to conduct complete audits of state Medicaid programs.
Sean Moran is a policy reporter for Breitbart News. Follow him on X @SeanMoran3
