AMAC Exclusive – By Sam Adolphsen
The nation’s largest welfare program, Medicaid, is a total mess. We are fast approaching 100 million people on the program, mostly because of expansions to able-bodied adults. States spend one of every three state budget dollars on the program – and more than one of every five of those dollars is spent in error. On top of that, states have been banned from removing ineligible people since early 2020 because of the so-called public health emergency that President Joe Biden keeps extending.
If Medicaid were a person, they would be drowning.
Now, the Biden administration’s Centers for Medicare & Medicaid Services (CMS) is proposing a new regulation that would make things much worse. The rule would make significant changes to state welfare eligibility processes, adding millions to welfare and adding $100 billion in new costs to taxpayers.
This latest proposed Medicaid rule would be like helping that poor drowning person by throwing them a cement block.
If President Biden is looking to finish off the program and send it to the bottom, he nailed it.
Of course, the administration isn’t really hiding its plan. The stated goal of the rule is to “maximize enrollment.” They talk about “retention rates” as if it’s a for-profit business, and how they need to “remove barriers to enrollment,” as if that’s a problem, with nearly a third of the country already on the program.
Biden’s 300-plus-page regulation has so many terrible welfare eligibility policies that it’s difficult to pick just a few on which to focus. But there are some that stand out as especially damaging to the integrity of the country’s safety net.
First, the new rule would prohibit all states from checking eligibility more than once a year. Under President Obama, CMS had already banned states from more frequent checks for certain populations. This proposed rule would expand that bad policy by making the previous minimum level of eligibility checks (once a year) the new maximum for everyone in the program. Some states check more often than once a year right now, and they should, because there are at least 16 million ineligible people on the program.
Second, the rule would ban states from requiring face-to-face interviews for any eligibility groups. This change comes despite the constant news about the significant problems with identity theft across all welfare benefits and COVID-19 unemployment programs. It is common sense that if states are going to hand out a costly welfare benefit, they should require one simple office visit before awarding that benefit. President Biden wants to ban that common-sense check.
Third, the rule creates an entirely new eligibility process for states, requiring them to keep cases open for months even after they determine someone is ineligible. This new “reconsideration period” would also force states to handhold someone to apply for alternative coverage before they can remove them from Medicaid. This also contradicts the entire stated justification for the rule, that it will “reduce the administrative burden” on states.
As if that weren’t bad enough, the rule would also require states to ignore returned mail if the new address is an in-state address. CMS outrageously claims that a change of address “does not indicate a change in circumstances.” Any reasonable person knows that isn’t true. A change in mailing address likely signals a meaningful shift in life circumstances that could affect eligibility.
Another crazy requirement in the Biden administration’s welfare proposal is that states will be required to accept as gospel certain government data sets. While this may seem smart at first glance, the policy only applies when the data indicates that the person is eligible for Medicaid. What happens if the data shows they are ineligible? Then the state must undertake a series of administrative-intensive follow-ups to ensure the person is ineligible. CMS only wants “administrative efficiency” when it will add someone to welfare, never when it would keep someone ineligible from being added.
One final bit of Medicaid madness is that the proposed rule would prohibit states from requiring ID verification as part of the process of reviewing an immigrant’s citizenship status when they apply for Medicaid. This is not surprising coming from Open Borders Biden, but it is alarming. There are many more problems with the proposal, including that it is probably illegal.
The bottom line is that one of the country’s chief safety net programs, Medicaid, has already been stretched and shredded by expansions to able-bodied adults and abysmal program integrity. Now Biden has doubled down, throwing program integrity completely out the window to push the country toward welfare for all. States need to step up and oppose this latest attack on Medicaid.