Republicans Can Easily Find Waste, Fraud and Abuse in Medicaid

Republicans in Congress are taking advantage of a generational opportunity to finally cut back on harmful regulations and wasteful spending, not just to the tune of billions, but trillions with a “t.” That’s real money.

That’s precisely what voters demanded: not nibbling around the edges and continuing “the way things are,” but bold, disruptive, and lasting change. And they gave Congress the power to make it happen with majorities in both chambers and by re-electing the most fearless disrupter of them all in Donald Trump.

With this Republican trifecta in place comes the opportunity to pass a reconciliation bill that not only extends — and even builds on and improves — the Trump tax cuts but also addresses the economic fallout from the Biden administration’s reckless regulatory and spending spree.

Here’s the best part: All of this can be achieved without a single Democratic vote.

Republicans are off to a great start, approving a strong budget resolution in the House that paves the way for the president’s “one big, beautiful bill.” With the Senate putting its important touch on the resolution by moving to a policy baseline that would make the tax cuts permanent, Republicans are on a clear glide path to a big, historic win.

Of course, Democrats understand this, and predictably, they’re in full panic mode. With the help of their friends, they’re waging a full-scale campaign to try to undermine the effort. Their last best hope isn’t to persuade the American people that their position is best for the country — the facts could never support that argument — but rather to parrot a false narrative that benefits are being cut for the truly needy.

This is patently false, and the Democrats know it.

The great irony is that the Republicans’ effort to target waste, fraud, and abuse in the Medicaid program will benefit the needy — the people the Democrats claim will be hurt. As Democrats push welfare on 20-year-olds who should be starting their careers, Republicans are standing up for the elderly, disabled, and children in poverty.

The other false narrative is that finding $880 billion in targeted budget savings in the Medicaid program over the next 10 years, as the House Budget resolution requires, is an impossible goal to meet without cutting benefits.

That’s another lie.

It turns out that Congress can easily exceed that goal with just a handful of reforms aimed at restoring program integrity, promoting work over welfare, and keeping undocumented aliens from stealing the benefits from Americans. Such reforms might include rolling back Biden’s “Streamlining Medicaid eligibility” rule, eliminating the Medicaid provider tax scheme, requiring able-bodied adults 18-59 without young kids to work, train, or volunteer at least 20 hours a week to receive Medicaid benefits, and imposing a 5 percent Federal Medical Assistance Percentage penalty on states that expand coverage to undocumented aliens. These reforms would produce up to $1.2 trillion in savings — far more than the $880 billion target.

Here’s the key: The savings reduction goal outlined in the budget resolution is a floor, not a ceiling.

While Congress must find at least $880 billion in targeted reductions within the Energy and Commerce Committee’s jurisdiction for the bill to comply with the reconciliation instructions outlined in the House resolution, there’s nothing to stop Congress from exceeding that goal. And it can, easily, without taking a penny of benefits away from those the Medicaid program is intended to help.

For instance, an additional $282 billion could be saved by requiring states to conduct more frequent Medicaid eligibility determinations to make sure those receiving the benefit are legally entitled to receive it. An additional $118 billion could be saved by setting premium contributions to 10 percent for subsidized Affordable Care Act exchange enrollees. Eliminating the enhanced FMAP for Medicaid expansion would produce $561 billion in savings, while removing the FMAP floor would save an additional $530 billion. The list goes on.

Altogether, my organization has identified $2.3 trillion or more in savings that can be achieved through smart, highly popular reforms aimed at targeting waste, fraud, and abuse in Medicaid.

Here are a few more facts. Over the past 10 years, Medicaid has doubled in size, and nearly tripled in size over the past 20. And notably, even if Republicans were to eliminate $880 billion in Medicaid waste, fraud, and abuse in the reconciliation bill, Medicaid will grow an additional 25 percent over the next 10 years. Clearly, no one is cutting Medicaid.

Republicans are staring at a big opportunity to get the country back on track through deregulation and spending cuts achieved through reconciliation, or what many are now referring to as the “DOGE Act.” With so much at stake, Republicans must not allow opponents’ lies to derail their effort to restore fiscal sanity and usher in the golden era for America.

Stewart Whitson is the senior director of federal affairs for the Foundation for Government Accountability. He wrote this for InsideSources.com.

Reprinted with permission from DC Journal by Stewart Whitson.

The opinions expressed by columnists are their own and do not necessarily represent the views of AMAC or AMAC Action.