Posted on 04/09/2018 8:07:34 AM PDT by SeekAndFind
Here are three ways to fix it.
Medicaid was intended to be a safety net for the truly needy. But over time, both federal and state policymakers have lost sight of Medicaid’s core purpose and turned the program into a catch-all, open-ended welfare program for non-disabled adults.
Obamacare made this problem even worse, giving states the option to expand Medicaid to even more able-bodied adults. Nearly 13 million have been added since that expansion went live in 2014. Today, able-bodied adults in the program now outnumber individuals with disabilities — the people Medicaid was largely designed to serve — by a staggering 17.5 million.
Medicaid has clearly lost its focus, as I detail in a new report for the Foundation for Government Accountability. The most stunning finding: At least 21,904 individuals have died on Medicaid waiting lists in states since they expanded their programs.
The waiting lists are comprised of individuals with intellectual disabilities, traumatic brain injuries, spinal cord injuries, and even the elderly. These individuals are waiting for additional Medicaid services — home- and community-based care, specifically — beyond what states are required to cover through Medicaid. Because these additional services are optional, states can limit enrollment in these waiver programs. Once that limit is reached, additional applicants are forced onto the waiting list.
To put a finer point on it: Expansion states have chosen to spend tens of billions of dollars on non-disabled adults instead of helping those on the waiting list. They’ve chosen to further strain the safety net by adding nearly 13 million more adults to welfare instead of helping people with traumatic brain injuries and other serious disabilities get the care they need. And we now know that at least 21,904 of these needy individuals have died before ever getting those services.
Medicaid is clearly broken. So, what can be done to protect limited resources and fix our broken Medicaid system?
First, states that have expanded Medicaid need to stop the bleeding by freezing future enrollment in their expansions. Existing enrollees would remain on the program until their incomes rise and they exit the program, just as they would anyway. But as they exit, resources would immediately be freed up for the truly needy.
Congress should also act by stopping new states from expanding Medicaid to able-bodied adults or by eliminating the enhanced funding that encourages states to prioritize able-bodied adults over the truly needy.
Second, states should pursue work requirements for all able-bodied adults in Medicaid. Prior presidential administrations never allowed states to adopt commonsense work requirements, despite their proven success in food stamps and cash welfare. Those days are over.
The Trump administration has allowed and is encouraging states to use the Medicaid waiver process to institute work requirements for able-bodied adults. The administration has so far approved Medicaid work requirements in Kentucky, Indiana, and Arkansas. CMS administrator Seema Verma recently said that eight states have Medicaid work requirement waivers pending and up to nine other states have expressed interest in the reform.
This is great news, because Medicaid work requirements can help move millions of able-bodied adults from welfare to work. States should continue pursuing them, and Congress should make the process easier by cementing Medicaid work requirements into federal law.
In order to crack down on fraud and protect resources, states should check eligibility more frequently and utilize data they already have, such as wage reports and death records.
Finally, states should attack welfare fraud with better data and more frequent eligibility checks. Waste, fraud, and abuse rob taxpayers and the truly needy of billions of dollars every year. According to the U.S. Department of Health and Human Services, most improper payments in the Medicaid program stem from eligibility errors — individuals enrolled in Medicaid even though they may no longer qualify or perhaps never did.
Just last month, for example, the U.S. inspector general announced that federal taxpayers spent more than $628 million on roughly 366,000 ineligible enrollees in California’s Medicaid expansion. The IG said another 79,055 were “potentially ineligible,” costing federal taxpayers an additional $402 million.
For those of you keeping score at home, that’s more than $1 billion — all money that could’ve instead gone to the truly needy. Meanwhile, since the state expanded Medicaid, 384 individuals on California waiting lists have died.
In order to crack down on fraud and protect resources, states should check eligibility more frequently and utilize data they already have, such as wage reports and death records. The Trump administration and Congress should also give states the express authority to check eligibility as often as they would like.
The Medicaid system clearly needs a serious overhaul. Policymakers must make Medicaid reform a top priority, and thankfully they have good options to get it done.
Not just abled-bodied people, able-bodied multimillionaire retirees in some cases who are able to minimize their MAGI and qualify for MCaid in the states w/expansion.
Don’t get me wrong, they’re not doing anything illegal, it’s just an interesting twist of the system. People who could literally afford to pay out of pocket or even afford the O’Care deductibles get free care.
I, for one, am not happy.
Most of the scammers simply refuse to re apply and drop out .
Scrutiny of the rest of the recipients allows denial to the able bodied scammers and and the ability more adequately fund the truly needy.
I know a profoundly handicapped cerebral palsy victim who can't even move with out help from aides who has been cut back and all but frozen out of the system due to perfectly healthy , able bodied scammers stealing all the funds.
One Man’s Safety Net is another Man’s Hammock.
Medicaid fraud, like food stamp fraud, is rampant. Taxpayers are being cheated out of Billions, with a B, of dollars.
I, for one, am not happy.
Over 10 billion dollars a year in welfare fraud in LA county alone.
Nationally it comes into the hundreds of billions per year.
WHY is there even the call to ‘fix’ that which should not exist in the FIRST place?
‘Safety net’...PFfft.
https://www.medicaid.gov/medicaid/eligibility/estate-recovery/index.html
State Medicaid programs must recover certain Medicaid benefits paid on behalf of a Medicaid enrollee. For individuals age 55 or older, states are required to seek recovery of payments from the individual’s estate for nursing facility services, home and community-based services, and related hospital and prescription drug services. States have the option to recover payments for all other Medicaid services provided to these individuals, except Medicare cost-sharing paid on behalf of Medicare Savings Program beneficiaries.
Under certain conditions, money remaining in a trust after a Medicaid enrollee has passed away may be used to reimburse Medicaid. States may not recover from the estate of a deceased Medicaid enrollee who is survived by a spouse, child under age 21, or blind or disabled child of any age. States are also required to establish procedures for waiving estate recovery when recovery would cause an undue hardship.
States may impose liens for Medicaid benefits incorrectly paid pursuant to a court judgment. States may also impose liens on real property during the lifetime of a Medicaid enrollee who is permanently institutionalized, except when one of the following individuals resides in the home: the spouse, child under age 21, blind or disabled child of any age, or sibling who has an equity interest in the home. The states must remove the lien when the Medicaid enrollee is discharged from the facility and returns home.
That’s what it was INTENDED TO DO.
Socialized Medicine via the bologna slice method.
USA slipping slowly slipping into Democratic party totalitarian communism. Like a frog in a pot of water with heat slowly rising.
How do husbandless mothers, fatherless children, ‘starving’ college students that could instead be working and illegal aliens fit into this problem?
Looking at the number of Medicaid and depending on the state, from 61% to 64% of people on Medicaid are aged 0-18 and are not adults from the Medicaid definition of adult.
From 26% to 28% are adults aged 19 to 64.
From 9% to 11% are age 65+.
What should be looked at is where the money goes. For the 60%+ who are children, the #1 expense is psycho drugs to prevent boys from acting like boys.
For adults 19 to 64 the #1 cost is addiction, addiction to alcohol, tobacco, opioids, and other legal and illegal drugs, including the related diseases associated with addiction such as liver and kidney problems, AIDS and HIV, STDs spread by those who are promiscuous while high, etc.
How much should we coddle addicts? That is the question to ask. And why do we have so many addicts? Is there a cause and effect between teaching school kids in school that drugs are the solution AND the use of drugs when those kids are adults?
RE: From 9% to 11% are age 65+.
I thought these folks are eligible for MEDICARE ( not Medicaid ).
RE: For adults 19 to 64 the #1 cost is addiction, addiction to alcohol, tobacco, opioids, and other legal and illegal drugs, including the related diseases associated with addiction such as liver and kidney problems, AIDS and HIV, STDs spread by those who are promiscuous while high, etc.
Could you kindly provide us with the official link for this? Thanks.
“both federal and state policymakers have lost sight of Medicaid’s core purpose and turned the program into a catch-all, open-ended welfare program for non-disabled adults.”
Nicholas, old boy, that was the plan all along.
L
Medicare requires that you pay a monthly premium of $100+
Medicare has deductibles and co-pays.
For many people, both SSI, SSDI and old age, guess who pays these costs? And depending on the state, there are things that Medicaid covers and Medicare does not.
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