My reason for saying that States should handle Medicaid is because a huge bloated Federal bureaucracy is incapable of policing itself.
A State, being smaller, has a better chance to discover fraud and abuse, keep costs down, then correct its own program. Why? Because voters are closer to the problem in a State and can have a huge impact on State programs via the ballot box. Not so much with Federal programs.
I would wager that 40% number would come down if there weren't stupid and wasteful Federal regulations involved.
Did you bother to look at the video? John better get on this like white on rice. There is little chance of cleaning up that nonsense, if they won’t even talk about it.