Medicaid reform must start with the states
Brian Blase has an excellent piece over at the Wall Street Journal that reminds us how much Medicaid’s funding system encourages states to chase federal dollars instead of responsibly managing their own healthcare programs. Expansion has incentivized the behavior in a way that is not only fiscally negligent but so far from the original purpose of the program, which is to care for the vulnerable and needy.
One example Blase offers:
- Medicaid abuse breeds corruption: Politically powerful healthcare providers enjoy windfalls, while states focus on maximizing federal Medicaid dollars instead of administering needed care. In 2023, Mr. Biden approved a California tax scheme that brought in federal funds for the state to expand Medicaid to illegal immigrants and have Medicaid cover long-term care for the Golden State’s wealthiest residents. Other states have followed California’s lead.
Clearly, the federal government should return Medicaid funding closer to its original purpose and make states pay for programs beyond its intent. States chasing federal money with a national debt approaching $37 trillion is a horrible look and something legislatures need to address.
— The Federalism Beat