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.
Most people agree on what seems to be a pretty basic fact: the same dollar cannot be spent twice. Money is finite. And when government spends a dollar – or several billion – giving welfare to people who shouldn’t receive it, logic follows that those dollars cannot then be spent on something else. Pretty simple, right?
Well, apparently not for everyone.
In his recent remarks to the National Governor’s Association, Vice President Mike Pence drove home this simple truth – that resources are limited and, as a consequence of that reality, ObamaCare’s Medicaid expansion has put “far too many able-bodied adults on the Medicaid rolls, leaving many disabled and vulnerable Americans at the back of the line.” The left proceeded to have a meltdown.
The problem for them – and for all of us – is that Pence was right. Continue reading
It’s officially 2017. A new year, full of new beginnings and opportunities. But for taxpayers and the truly vulnerable in ObamaCare expansion states, it’s the continuation (and acceleration) of a nightmare. As of January 1, states are on the hook for 5 percent of the expansion’s costs. And with more enrollees than states expected to ever enroll, this fiscal nightmare will be even worse than expected, putting taxpayers and the truly needy at even greater risk. 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.
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.
The Illinois General Assembly opted to expand Medicaid through Obamacare in May 2013. This expansion created a new Medicaid category for able-bodied adults ages 19-64 with incomes below 138 percent of the federal poverty level.
But the Medicaid program was designed to serve the truly vulnerable – the aged, the blind and the disabled – and expansion critics have long warned that creating a new welfare class would prioritize able-bodied adults and put more vulnerable people at risk by redirecting limited resources. Now, newly obtained data from the Illinois Department of Human Services, or DHS, confirm these fears.
According to documents provided by the department, 752 Illinoisans on the state’s Medicaid waiting list have died awaiting needed care since the General Assembly voted to accept the Obamacare expansion for able-bodied adults. That’s 18 deaths each month, on average, since the expansion was authorized. Continue reading