When Medicaid was created in the mid-1960s, it was intended to provide medical care for people who truly had nowhere else to turn—namely, individuals with disabilities and the elderly. But over time, the program has ballooned, now serving 76 million people.
Even worse, nearly 40% of enrollees are now able-bodied adults. There are close to twice as many able-bodied adults in Medicaid today as there are elderly and individuals with disabilities combined.
Medicaid’s rapid growth is no secret, and it’s cause for concern across the country. Those who work with state policymakers see it firsthand—state leaders realize how consuming Medicaid has become. From Maine to Montana, the overwhelming growth of the program is often at the top of their minds.
That’s because it quite literally dictates state budgets: Medicaid gets paid first. Everything else (including education, infrastructure, and public safety) gets the scraps. Continue reading
Almost exactly one year ago, Arkansas became the first state to ever implement commonsense work requirements for able-bodied, working-age adults on Medicaid—and the far Left freaked out.
Since that time, they’ve proceeded to outright slander the state, falsely asserting that the requirement would leave the state worse off, hurt Arkansans, and was nothing more than a “reporting requirement” designed to confuse enrollees with paperwork rather than help them find a job. They’ve waged an all-out war on work, even using the courts to try to (temporarily) thwart the will of Arkansans, who overwhelmingly support the requirement—Republicans and Democrats alike.
They’ve gone all out for a few big reasons: they want as much dependency as possible. They think a life-long welfare check is better for Americans than a paycheck. And they also know that Medicaid work requirements are a signature achievement of President Trump’s first term.
If they can stop Arkansas, they think they can stop work requirements from spreading to other states, increase dependency, and deal a blow to President Trump at the same time. For the far Left, it’s a win-win-win.
But there’s bad news for them: from Day One, they’ve been wrong about Arkansas’ commonsense welfare reform, and a new study from the Foundation from Government Accountability proves it. 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.
Earlier this week, The Oklahoman editorial board published an editorial praising Oklahoma policymakers for rejecting ObamaCare’s Medicaid expansion. As evidence, they cited FGA’s new enrollment explosion report.
From The Oklahoman:
During the 2016 legislative session, there was a strong push to expand Oklahoma’s Medicaid program to obtain funding from the Affordable Care Act. Ultimately, lawmakers declined to take that step. It’s proving to be a wise decision…
A recent report by the Foundation for Government Accountability notes that expansion enrollment exceeded projections by 322 percent in California, 276 percent in New York, 134 percent in Kentucky, 90 percent in Illinois, 60 percent in Ohio and 51 percent in Arkansas.
That means the cost of the 10 percent state share for Medicaid expansion will be commensurately higher as well. And federal data shows that Medicaid expansion spending was 49 percent higher per enrollee in 2015 than what was predicted when the law passed in 2010.
At the same time, Medicaid expansion isn’t generating the savings supporters promised, such as lowering the use of emergency rooms for routine care.
You can read the full editorial here.
Today, the Foundation for Government Accountability released a new report, authored by myself and Jonathan Ingram. We surveyed every ObamaCare expansion state, comparing enrollment projections to actual enrollment.
Here’s what we found:
Altogether, 24 states that accepted ObamaCare’s expansion released enrollment projections in advance and have since reported at least one year of enrollment data. In total, these 24 states promised that “only” 5.5 million adults would ever sign up for ObamaCare expansion. However, actual sign-ups have surpassed these projections – and not just by a little bit. Continue reading
By Josh Archambault and Nic Horton
Why should the exact same treatment for pneumonia cost $5,000 in one building and $124,000 in another? Or the exact same infusion drug for a chronically ill patient that requires them every six weeks cost $14,000 per shot in one setting, but $28,000 down the street? Why should patients have to pay so much more, simply based on where they park their cars? The answer is simple: they shouldn’t.
But the black box of pricing leaves patients in the dark. As a result, the financial futures of too many American families are in jeopardy as their paychecks fail to keep up with skyrocketing health care costs.
In state capitols across the country, health care lobbyists and consultants are pushing a relatively unknown provision of the Affordable Care Act (ACA): Section 1332. According to some proponents, these waivers will “turbocharge state innovation” and will provide states with an “exit strategy” from the ACA. But is the hype true? Will Section 1332 waivers be as truly transformative to our health care system as suggested?
As policy practitioners who work daily with state policymakers around the country, we have seen proponents be overly dismissive—or perhaps even unaware—of the large practical and political challenges surrounding the implementation of these waivers. A serious, objective examination of the new Section 1332 federal guidance sparks far more questions than answers for policymakers. Continue reading
Co-authored by Nic Horton, Jonathan Ingram and Josh Archambault
For too long, thousands of Kansans have languished in welfare, without hope of a better life. But thanks to one simple policy change, many Kansans are now on the path to a better life.
Under federal law, all able-bodied, childless adults in the food stamp program are required to work or train for work at least 20 hours per week. But with help from the Obama administration, most states have been waiving those requirements in recent years. Last year, for example, more than 40 states waived these critical requirements, fostering a culture of long-term dependency.
But in 2013, Kansas Governor Sam Brownback bucked the trend and instructed state officials to reinstate work requirements and time limits for able-bodied adults. Within three months, half of all able-bodied adults on food stamps had cycled off the program. Enrollment is now 75% lower for this group of adults than it was before work requirements took effect. Continue reading
By Jonathan Ingram, Nic Horton and Josh Archambault — Mr. Ingram is Research Director, Mr. Horton is Policy Impact Specialist and Mr. Archambault is a Senior Fellow at the Foundation for Government Accountability.
Governors across the country are leading a new welfare reform revolution. From Maine to Indiana to New Mexico, bold leaders are making common-sense changes that will preserve the safety net for the truly needy.
As this revolution continues to spread across the map, state policymakers need to know these policy changes – restoring work requirements for able-bodied adults without kids on food stamps – are already having transformative results for enrollees and taxpayers.
Work Waivers Foster Dependency
Although federal law requires able-bodied childless adults on food stamps to work or search for work, 42 states partially or fully waived that requirement in 2015. These waivers allow able-bodied adults to stay on the food stamps rolls indefinitely, regardless of whether they’re looking for work.
It’s no surprise, then, that able-bodied adults are staying on food stamps longer than ever, costing taxpayers and the truly needy who rely on the food stamp program for survival.
By Nic Horton, Jonathan Ingram and Josh Archambault
Over the last several years, even as the economy has started to improve, more and more Americans have become trapped in the food stamp program, now called the “Supplemental Nutrition Assistance Program” or SNAP. In 2013, food stamp enrollment and spending hit all-time highs.
But a new report from the Foundation for Government Accountability provides governors and legislators with a roadmap to reverse this trend. The first step: getting able-bodied adults work-oriented and eventually off of welfare.
Able-Bodied Childless Adults Drive Food Stamp Explosion
So what’s causing the rise in food stamp dependency?
One key contributor is the growth in able-bodied childless adults on the program. Between 2000 and 2008, the number of able-bodied childless adults receiving food stamps hovered at or below one million.
But by 2013, a record-high 4.9 million able-bodied, childless adults were receiving food stamps. Federal spending on food stamps for these able-bodied adults skyrocketed to more than $10 billion in 2013, up from just $462 million in 2000.