Lawmakers in Congress have unveiled their year-end omnibus $1.7 trillion spending bill. They’re hoping to pass it by the end of the week. The draft text comes after weeks of wrangling over how to fund certain COVID-era healthcare policies after July, when the public health emergency is finally expected to expire.
Among them is a Medicaid policy that has bloated the entitlement and spent huge sums on people who should not be eligible for coverage according to the program’s own rules. In March 2020, Congress offered extra Medicaid funding to states as long as they didn’t kick ineligible enrollees off the program’s rolls or change eligibility requirements for the duration of the public health emergency. The intent was to ensure people had continuous health insurance throughout the pandemic.
AMERICA’S HEALTHCARE SYSTEM FACES FISCAL IMPLOSION, BRITAIN’S FACES FUNCTIONAL IMPLOSION
Democrats have reportedly agreed to allow states to remove ineligible people from their Medicaid rules on April 1 — three months before the Congressional Budget Office assumes the public health emergency will expire. The move is long overdue. More than 73 million people are currently covered by the program. That’s an increase of 15% since February 2020. The Congressional Budget Office estimates that 13 million of them are ineligible. An Urban Institute report puts the number at 16 million.
It’s no wonder nearly 16% of the payments Medicaid made in 2022 were “improper.” That amounts to $80 billion in payments that “do not meet program requirements” — a broad definition that includes fraud, clerical errors, and payments made on behalf of people who aren’t eligible for enrollment. And as a new report from the Paragon Health Institute points out, that’s likely an undercount, since the government greatly reduced improper payment data collection during the pandemic.
Democrats have already extended the COVID-era Medicaid policy long past its expiration date. It’s time to restore some sanity to Medicaid — by ensuring that the program follows its own eligibility rules.
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Sally C. Pipes is president, CEO, and the Thomas W. Smith fellow in healthcare policy at the Pacific Research Institute. Her latest book is False Premise, False Promise: The Disastrous Reality of Medicare for All (Encounter 2020). Follow her on Twitter @sallypipes.
