In 2013, the Arkansas legislature voted to expand Medicaid to able-bodied, childless adults through ObamaCare. One of the primary motivations behind this decision—if not the primary factor—was the hope that expansion would save hospitals from certain demise. But after nearly six full years of expansion and hundreds of thousands of able-bodied adults added to welfare, Arkansas’ hospitals are still struggling—and many of them have closed.
This comes as no surprise to those of us who can plainly see that expanding welfare doesn’t create jobs or bolster economic activity. (Indeed, it does quite the opposite.) But still, these hospital closures simply cannot be overlooked, especially as more states consider whether or not to bring this same nightmare home.
Just this week, news reports out of Arkansas classified the health of the state’s hospitals as “condition critical.” Continue reading
Medicaid is out of control and unsustainable. Work requirements could help.
It’s not the lead story on the nightly news, and it’s not generating millions of clicks online. It may be one of the most underreported, underappreciated public-policy crises of our time. That’s a terrifying reality because, left unaddressed, this crisis will come at great cost to America’s most vulnerable.
The Medicaid program is at its breaking point. Even before Obamacare lured some states into expanding the program to non-disabled, working-age adults, Medicaid was growing at an alarming rate. Now, in the Obamacare era, the program is growing even faster, siphoning more and more resources away from folks who truly depend on Medicaid for survival.
A new report, released this week by the Foundation for Government Accountability, gives a glimpse of just how serious the problem is.
The state of Maine has long been on the leading edge of welfare reform. Under Governor Paul LePage, it has reformed its food-stamp program by promoting work, resulting in former enrollees’ more than doubling their incomes the following year. Maine has also worked tirelessly to find and prosecute welfare fraud, going after those who steal limited resources from the people who most need help.
These efforts, combined with Maine’s rejection of Obamacare’s Medicaid expansion, have allowed the state to make the truly needy a priority. But Maine’s not slowing down. Continue reading
Arkansas made national headlines in 2013 when then-governor Mike Beebe, a Democrat, struck a deal to make Arkansas the first southern state to expand Medicaid through Obamacare. Shortly thereafter, Beebe exited (stage left), leaving a fiscal, political, and moral disaster for the new administration to grapple with. But now, thanks in large part to the leadership of Republican governor Asa Hutchinson, Arkansas is taking significant steps toward reversing Obamacare’s devastating impact. Other expansion states should take note. Continue reading
One of the most significant yet underreported outcomes of ObamaCare is its impact on the truly needy. Before ObamaCare, our country maintained a safety net that was reserved for our neediest neighbors. The Medicaid program, for example, primarily served poor children, seniors, and individuals with disabilities.
But ObamaCare’s Medicaid expansion sought to change this. It sought to transform a safety net into an open-ended, free-for-all welfare program for non-disabled, working-age adults, the overwhelming majority of whom have no dependent children at home. Every penny spent on this new population is a penny that can’t be spent on the truly vulnerable. That’s just a fact.
Many of these individuals – nearly 600,000 nationwide – currently sit on Medicaid waiting lists, hoping to get additional services that states say they need but, due to limited funding, states can’t afford. Literally, states have said, “You need this service but we do not have the adequate funding to provide it for you.” As a result, these individuals sit and wait. Many of them will die before they ever get the care they need.
Some might call that rationing. At best, it is misprioritization. Continue reading
By a vote of 55 to 32, the Arkansas House voted yesterday to pass HB1465. The bill, sponsored by Republican State Rep. Josh Miller, would require the Department of Human Services to ask the Trump administration for an enrollment freeze in the state’s out-of-control Medicaid expansion program. No existing enrollees would be removed but no new applications would be accepted. The bill provides what could be a blueprint for lawmakers in D.C. who are looking for options to unwind ObamaCare.
HB1465 flew through the Arkansas House Public Health & Welfare committee earlier this week by a vote of 13-6, even garnering the support of some previous Medicaid expansion supporters, including Committee Chairman Rep. Jeff Wardlaw. Wardlaw, who voted for the initial expansion in 2013, was a Democrat at the time, but switched parties last November, just weeks after the election.
And Wardlaw is not alone. Yesterday, on the floor of the House, multiple members of both parties who have previously supported Medicaid expansion voted in favor of Miller’s commonsense proposal. Many of them voted for the original expansion proposal back in 2013.
The progression of HB1465 through the legislature is demonstrative of the political realignment happening not just in Arkansas but in expansion states across the country. Continue reading
When Arkansas legislators and then-Governor Mike Beebe expanded Medicaid to able-bodied adults through ObamaCare, supporters claimed their plan was something other states were closely watching and, before it was even implemented, was serving as a national model. What unfolded, however, was a fiscal and moral disaster that no other state dares to fully replicate.
Recent reports indicate that Arkansas’ ObamaCare experiment is nearly twice as expensive per-person as a conventional Medicaid expansionwould have been. If that weren’t bad enough, more able-bodied adults signed up for this welfare expansion than state officials promised would ever even be eligible.
Now as state taxpayers begin feeling the brunt of budget shortfalls and skyrocketing enrollment, one Arkansas lawmaker is working to stop the bleeding. Continue reading
Experts have long raised questions about the budget gimmickry involved in the Obama administration’s approval of Arkansas’ Obamacare expansion waiver. The Government Accountability Office even warned that the administration and Arkansas cooked the books to secure the waiver. But now, the state’s own evaluation of the program – spearheaded by one of the program’s architects – shows just how badly Arkansas got it wrong. Continue reading
Policymakers in the Land of Lincoln have some important work to do this year to preserve limited state resources for the truly vulnerable. Stopping the enrollment of able-bodied adults in Illinois’ Medicaid expansion program, and instituting work requirements for able-bodied adults in Medicaid are necessary to safeguard the program for Illinoisans most in need of services.
A Medicaid enrollment freeze waiver can preserve resources for truly needy Illinoisans
To stop Medicaid expansion enrollment, Illinois policymakers should ask the Trump administration for an enrollment freeze waiver. The program is devouring state tax dollars that could go to help Illinois’ truly needy residents, including the 18,000-plus Illinoisans on Medicaid’s Prioritization for Urgency of Need for Services waiting list. An enrollment freeze waiver would allow state officials to stop the hemorrhaging of Medicaid dollars and begin to immediately prioritize truly vulnerable Illinoisans once again.
Medicaid work requirements can prevent the safety net from becoming a poverty trap
But that’s just the beginning of what Illinois officials must do to reform the state’s overgrown and unsustainable Medicaid system. The state should also request a waiver to institute work requirements for all able-bodied adults in Medicaid. Medicaid’s safety net has become a web that traps too many Illinoisans in dependency. But with the requirements in place, the truly vulnerable and taxpayers will find much-needed relief. Equally important, enrollees will be better able to transition to self-sufficiency.
Currently, Illinois’ Medicaid program is operating as a welfare trap – a system that encourages individuals to remain in dependency indefinitely and penalizes them if they try to leave. There’s perhaps no better proof of this phenomenon than the number of Illinoisans who are in the Medicaid program and not working at all.
According to the most recent data from the U.S. Census Bureau, less than one-third of all able-bodied, working-age Medicaid enrollees in Illinois work full time. By contrast, nearly 36 percent don’t work at all.
In addition, according to data from the Department of Healthcare and Family Services, nearly 54 percent of able-bodied adult enrollees in the Medicaid expansion reported no income at all in 2015. Continue reading
Illinois’ Medicaid program has spiraled out of control. Since opting to expand Medicaid through Obamacare, the state has enrolled roughly 650,000 able-bodied adults – nearly twice as many as the state said would ever even qualify, much less enroll. Over that same period, 752 truly needy Illinoisans have died on a waiting list for medical treatment. And with a large Obamacare bill due in less than a month, policymakers should start working now to put the brakes on this nightmare.
Thankfully, simple, tested and effective policy solutions exist to the challenges facing the state. By freezing enrollment in its Medicaid expansion program, Illinois can immediately begin protecting resources for its truly vulnerable citizens and help Illinoisans currently trapped in welfare get back on the path to independence. In addition, lawmakers would immediately provide much-needed relief to overburdened state taxpayers.
Enrollment freezes are simple: Rather than pulling the plug on the expansion program overnight, the state would allow current enrollees to stay for the time being, but would stop enrolling new members. This allows lawmakers to gradually wind down the program over time, but immediately free up resources for the truly vulnerable.