AMAC Exclusive – By Sam Adolphsen
When you hear or read about Medicaid, one of the largest welfare programs in the U.S., the connection to Ernest Hemingway might not be immediately evident.
However, a piece of wisdom from Hemingway’s character Jake in The Sun Also Rises applies to the challenges facing Medicaid today: “Getting something for nothing only delayed the presentation of the bill. The bill always came.”
Nowhere is that sentiment truer than in the Medicaid program. And the bill is coming due in states around the country. Taxpayers and the truly needy had better look out, because the bill must be paid.
Medicaid (not to be confused with Medicare) is a program that was meant for the truly needy, the elderly, the disabled, and poor children. That was before Obama expanded the program to tens of millions of able-bodied adults, including adults with no kids at home, as one of the most controversial parts of Obamacare.
Just twenty years ago, there were only 7 million non-disabled, working age adults on Medicaid. Today, after a decade of Obamacare’s Medicaid expansion, which was partly funded by hundreds of millions of dollars in cuts to Medicare, there are nearly 40 million able-bodied adults on the program.
That means almost half of the people on Medicaid, a program meant for the truly needy, are able-bodied adults who can and should be working. But most of them are not working. State data shows that more than half of those tens of millions of able-bodied adults don’t work at all.
This unrestrained growth in Medicaid, especially among able-bodied adults, is having a major detrimental effect on state budgets. In recent years, the COVID-era deficit spending from Washington D.C. included extra Medicaid funding for states and papered over the budget problems.
Now with that extra federal money going away, the bill has come due for many states. More will soon follow.
California is facing a record budget shortfall of $68 billion after further expanding Medicaid to cover illegal immigrants and raising the income limit well into the middle-class.
New York is facing a $7 billion shortfall this year, much of which can be attributed to an increase of $10 billion in Medicaid costs in just one year. It doesn’t help that New York is also giving Medicaid to illegal immigrants and proposing a new scheme to keep people “continuously covered” for years with no eligibility checks.
So how will New York handle the bill coming due? Predictably, and sadly, by proposing cuts to care for the elderly and truly needy. The governor has already proposed a budget that cut tens of millions that was going to struggling nursing homes.
Where is the discussion of reining in the runaway costs and enrollment of millions of able-bodied adults? Nowhere to be found in New York.
Indiana, which foolishly expanded Medicaid to able-bodied adults years ago despite being a solidly red state, now faces more than a billion-dollar shortfall in Medicaid—just as many conservative opponents of the policy predicted at the time. The Indiana Family and Social Services Administration initially proposed cutting back a service that helps provide in-home care for elderly and disabled individuals. Meanwhile, almost half of Indiana’s two million people on Medicaid are able-bodied adults.
Arizona, another Medicaid expansion state, is facing a huge budget shortfall that could total in the billions of dollars. While the Democrat governor is trying to blame the shortfall on tax cuts and school choice, the reality is that Medicaid expansion is driving the problem. Arizona had just 500,000 people on Medicaid in 2000. After expanding Medicaid, they now have 2.3 million on the program. Nearly a million of those are able-bodied adults.
These are just a few of the states grappling with the Medicaid expansion budget problem. Colorado can’t cut property taxes like they want to because of Medicaid overruns. Maine is proposing to spend millions to hire new state workers to process Medicaid applications after expanding.
The Biden administration is making this problem worse. The Biden Medicaid office, run by the former Attorney General of California, has done everything in its power to keep states from limiting the growth of able-bodied adults on their welfare programs.
The Biden administration has even threatened states that have tried to clean the rolls up after COVID and demanded the adoption of policies that open the door to even more enrollment. This includes, no surprise, pushing states to adopt Medicaid expansion to even more able-bodied adults.
Unless states get the growth in able-bodied adults on their programs under control, there will be proposed cuts to the elderly and truly needy. There will be blown opportunities to cut property taxes. There will be cuts to road repairs and public safety. Or worse.
States that have avoided this Medicaid meltdown like Kansas, Texas, Florida, Alabama, Tennessee, and Mississippi, should stand strong against Medicaid expansion to protect the truly needy who depend on the program, and the taxpayers that fund it.
The bill will always come due. The only question is, who will pay?
Sam Adolphsen is the policy director at the Foundation for Government Accountability, and the former Chief Operating Officer for the Maine Department of Health and Human Services where he oversaw welfare eligibility and fraud investigations.
So sad that we don’t make the lazy go to work. Prove the need or cut the benefit.
We need MEANS TESTING.
I am 68, still working, an entrepreneur and have started multiple business, pay employees well provide health insurance, and provide incentive packages. We do terminate those who won’t do their jobs. I have taught my kids and employees some very important words, “we cannot afford that”. The government needs those words as well after all it isn’t their MONEY.
Biden Opened the Border that President Trump had brought under control even fighting the Republicans in the Congress.
Now Biden says he said he needs Power to close the Border he truly has lost his mind! Who is the Puppet Master? I believe Barack Obama and his henchmen!
Lord Help us save our Constitution and Republic.
I have wanted to move to Tennessee for at least 10 years now. Currently in the Democrat coup state of Az.
I have been Tenn many, many times because of my career. They have at least one really good senator in Marsha Black.
The fact that state does what others do with no state income tax, lower property taxes, minimal vehicle registration fees and more shows it is not huge money going to corrupt organizations that make things happen, it is people. If you eliminated the corruption in our federal budget I’m sure it could be cut in half.
When the Democrats buy votes by giving away “free” stuff, many love the feeling of being compassionate and caring without taking into account the fact that free stuff attracts freeloaders who sponge off voters’ compassionate and caring feelings.
Sam, you have (either by accident or choice) have aptly defined vote-buying, no more – no less.
It should be obvious that the left wing democrats are deliberately trying to destroy the country.
As if Obama didn’t know this would be the outcome. Announcing the negative consequence of what Obama did is pointless because he is probably celebrating over this.
Fear not, all our govt tax money will be directed to the illegal invaders and we who the bills will be slaves with next to no benefits. This all brought on courtesy from the government that hates it’s citizens.
This is a tragic crisis as Obama and Biden insist on #redistribution of wealth” The Millions of immigrants immediately receive Medicare in addition to cell phones, lodging etc. This policy will Rob our Taxpayers with a burden that has truly impacted the average to above average citizen.
Having two senior friends truly in need and inability due to age cannot retain the home
nurse care ordered. The Medicaid is too little for this service . They quit.
We must close border and take care of American Legal Citizens. We Vote this year.
Write to our representatives. They have golden package of health care to death.
We need fiscal leadership and rework this current structure.
Next Bidens chickens come home to roost
someone needs to explain to me how anyone that actually works for a living could vote for a democrat.
#FJoeBiden et al.
can’t congress pass a law that will stop the expansion of medicaid and reduce it for what it was I guess not with DEMOCRATS in charge of the senate and president.
The working able bodied Americans. People on Medicare because they take from Medicare to give to Medicaid. And why are they adding still more able bodied people to the Medicaid rolls. To bankrupt the states, and thereby the country. O has this still in hand. This whole social medicine experiment known as O care has been a disaster. After all P said we need to pass this 2,000 page bill to know what is in it. The cart before the horse and now the bill is due. Millions of people who could work are on Medicaid on the taxpayers dime. Do we still want the dems govern 4 more years? I say throw the bums out before America and the dollar go down the drain. And we fly the Chinese flag and we are all standing in soup lines again.
I know who is going to pay for the fiasco… middle-class WORKING WHITE CHRISTIAN AMERICAN CITIZENS! The mohamedans as imported by George Bush won’t pay, but probably 90% receive the benefits…the illegal Mexicans as allowed across the border by Bush/Obama/Biden won’t pay, but 90% receive the benefits…and the whining, lazy, out-of-control criminals in America’s cities as coddled by every president since LBJ won’t pay, but 90% receive the benefits. But our Christian God tells us to love and nurture…the immigrant moslem who will cut our throat without a shudder when the ‘Call’ to exterminate the INFIDEL goes out from pulpits; we are told to love and nurture our poorer immigrants from the south who only come here as an act of respectful LOVE as the BUSH FAMILY taught us…although they come “for the money!” and to rape our women and girls, and addict our teens to their sweet singing ‘siren’ of Chinese FENTANOL….and of course we must love and nurture our poor blacks who each and every one of us harmed so vividly through the horrors of 80 years of American slavery…whatever we expend on their behalf, it will never be enough! But we will pay…the American citizens of ‘fly-over’ country will pay, even though it is the educationally propagandized liberal voters of California, Illinois, New York, Massachusetts, New Jersey, Minnesota/Michigan, Washington/Oregon, even here in Colorado…we will pay!
The solution is so simple, even an idiot should be able to figure it out. WHY is no one willing to do the right thing?
Those in the USA illegally and able bodied citizens should NOT be allowed on Medicaid! There, I fixed it!!!
There is absolutely no acceptable reason for any able bodied citizen or any person in the USA illegally to ever get a cent of help from medicaid.
As Margaret Thatcher said–‘Sooner or Later you run out of other people’s money to spend”.
Crashing state’s economy is one of main goals of the Commie/Globalist/Demonrat traitors … necessary if they are going to “fundamentally transform” our Constitutional Republic (with freedoms and opportunities for ALL LEGAL Americans) INTO their totalitarian tyranny hell! for anyone not in their evil club. Commie Traitor Obamie’s disastrous Obamacare was designed not to reform and better health care, but to aid in their goal of destroying our very way of life as free citizens.
This props up the truth above: (under corrupt fraud puppets JoeBama) “The Biden Medicaid office… has done everything in its power to keep states from limiting the growth of able-bodied adults on their welfare programs.”
Omama and his Marxist lying ilk designed it to intentionally collapse the system. That was their specific intention.
Think I’ll go spend all my savings on fences for the neighborhood (because I’m inherently responsible to keep strangers out of THEIR yards) then run up my credit cards to their limit then pay the minimum payment amount each month afterwards request increases to my card limit! If this makes perfect sense to you, you must be a Democrat!
Who will pay? That’s an easy question, those of us who work and pay taxes. I foresee tax hikes in the future, until we pay more in taxes than we take home. That creates more people who need help. It’s a vicious cycle, one that has been planned on the road to socialism. Well end up like Venezuela and Argentina (which I hope Milei can fix). Conditions will have to get much worse before people will stop voting for these left wing loons.
The bill should be paid by the salaries of ALL who expanded it.
This disaster started when healthy able bodied were paid for nor working and out of wedlock births were rewarded It mushroomed into what it is now and not once was it seriously questioned it’s a big enterprise funded by taxpayer and milked by those involved in it
All according to plan. The idea is to create a nightmare that will have ‘the masses’ braying for universal healthcare. What that will mean is that lazybones who never worked will get the same medicare someone who worked from 16-70 gets. Medicare will of course collapse and a new form of rationing will prevail. The dems have already been pushing ‘Medicare for All’. Expect this as a front burner issue if they steal the election coming up.
This clown nobummer is the worst lying muslim president in U.S. history. he was neither born in HAWAII nor a christain….
Has Margaret Thatcher once said socialism is great until you run socialism is great until you run out other people’s money
I’m surprised AMAC printed Sam Adolphsens’ article. AMAC advertised and supported ACA plan benefits aka Obamacare in November 2022 and 2023. I sent emails asking why AMAC would support ACA after Dan Weber and members fought so hard against the bill. Never got an answer.
Tax payers pay the bill for the obiden regime as always. Go kick these losers in the backside and send them to work. Trouble are the moron docs who continue to give them physical “conditions “.
Yes, Obama sure did whip up some nasty, tubercular “chickens” for us on many fronts… as those who self-worship that much have that tendency…
…on the other hand, Biden has proudly perfected his own unique brand of cerebral lethargy…. like some kind of live shellfish that’s been in the fridge for a few days before the cookout… “Hey, look at me, everybody – I can’t react to my own appalling stimulae !!!”
As soon as the wicked witch of the west said: We have to pass it to find out what is in it, (about the affordable care act) I knew we were hosed. Have we learned anything?
Anything the stinking democrats touch they destroy.
Here in Michigan, TEA Party Patriots tried our best to get the Republican controlled State to Not go along with the medicaid expansion.
I know that because I was the local chair for our Tea Party. What a disappointment it was passed then. We were warning of the great pitfalls of our future, and here we are.
Sure, there was a little room for limited expansion, but not what’s happened. Definitely growing in numbers since the democrats stolen elections. All of it’s worse than ever now. The ‘rainy day funds’ once grown with taxes cut, and more with the obscene passages of amendments using election maladministration.
Cheaters cheat, thieves steal, and liars lie.
DrScottD
That has always been the problem with obamacare. Someone has to pay for it.
That’s why NYS is considered a blue state despite the impact of misusing funds collected from the already TOO HIGH STATE and LOCAL TAXES while crying that they lost the ability to “deduct” those taxes in full from the federal tax liability. As someone who will never reach a high enough income to convert income from earned income into investment income, while trying to stay afloat financially because my earned income is too high to qualify for “free benefits” but I have no resources to flee NYS as the elitists do, so I have to deal with the mess created by progressive thinking who also use NIMBYISM to keep the problems they created away from their actual reality. These elitists are always protesting DEI for as long as it doesn’t involve their lifestyle changes. We just had 2 murder deaths in Yonkers, NY within 2 weeks and the mayor and the City Council who just gave themselves a large raise without approval by ballot vote, are crying about the lack of funding sources for all their expenses. 33% of the residents in the city of Yonkers failed to be counted by the Census because they failed to respond. Yet, the City estimated the population growth to increase their funding from the state because 33% are undocumented under the sanctuary status claim. Most ( at least 49%) of the taxpayer residents don’t want or approve of these actions but unfortunately, fail to show up to vote in enough numbers to change the situation.
This was the end plan of “Obama care” all along. Put more and more people on Medicaid, which would bankrupt state budgets as well as private insurance companies that will have to raise rates to unaffordable levels as providers charge them more to make up for the low reimbursement by government programs. When it all implodes the “benevolent” government will step in and simply place everyone into a single payer system. In 2009 Obama predicted it would take about ten years to get there. We’re nearly there. Hello tax hikes, rationing, inferior care, and the best and the brightest doctors leaving the fields or caring only for the very richest who can self pay.
The question “who will pay” — we all know the answer to that. It is always those working who pay more in taxes to cover the ever-increasing governments’ actions to have everyone beholding to them. That means eventually all workers become slaves and receive only what the gov’t decides they need to survive. When no longer able to “pull your weight”, you will be cast aside to die or outright killed (likely in secret.
When you tell the world that they can get free health care here, they’re going to come and get it. Can’t blame them, but the golden goose is on its death bed with no healthcare for it in sight.
Forgot to add, that only full time jobs get medical coverage..what if too ill to work full time? What if the coverage is so poor, that you are left without $, due to medical bills?
You can work 3 part time jobs, with no medical
Walmart has their employees getting medicaid and food stamps and only hires part time, as most places do..or worse, just shy of 40 hrs!
But, I know no one owes us anything..
My ill son, gets medicaid and the only way to prove disability, legally is a claim with social security..if you have never worked you can’t do that! What are we to do?