Disingenuous lies spread on Medicaid reforms

Ignore the panic that the political left tries to foment in Louisiana about changes to Medicaid. Instead, consider how their lies crumble against the reality that the new law will improve program delivery for those who truly need it.

The biggest falsehood to emerge from the left’s talking points is the myth of Medicaid “cuts” (excoriated on the floor of the Senate recently by Republican Sen. John Kennedy). There are absolutely no cuts in Medicaid spending in the reconciliation bill now known as the One Big Beautiful Law. In fact, Medicaid spending is set to increase by an average of three percent annually over the next decade.

Nor will any eligible person lose Medicaid coverage who is a disabled adult or one who has dependents younger than 14. The only change here is that able-bodied adults without all but older dependents will have to meet a community engagement requirement of employment, enrollment in an educational program, or volunteering only 80 hours a month. In fact, most ABAWDs already meet these criteria.

As for ineligible recipients, they will have to face increased enforcement efforts. Pending Democrat former Pres. Joe Biden Administration rules that would weaken eligibility determination were postponed nearly a decade. Among state and federal governments increased data sharing and penalization for abnormally-high improper payment rates will clamp down on waste that, the Centers for Medicare and Medicaid Services estimate, just for illegal dual enrollment will remove 2.8 million accounts and save billions of dollars. And it creates much greater vigilance to prevent illegal aliens from accessing the system (as well as for Medicare), savings tens of billions more.

Also, the law clamps down on incentives for states that have and have not expanded Medicaid to include this expansion with people not among the poorest who the program originally intended to cover, such as by imposing modest cost-sharing among recipients of expansion coverage. As well, it inhibits states from using the money-laundering scheme known as provider taxes – which basically pass through to consumers in the form of higher costs out of pocket and in health insurance rate increases – as a way of sticking taxpayers with higher matching amounts.

In short, not a single person will lose Medicaid benefits who meets the original eligibility criteria or who are citizen and many legal alien ABAWDs of higher incomes who fulfill community engagement requirements. The left tries to deflect from this truism with red herrings.

Most prominently, it claims significant swaths of eligible people, facing marginally more detailed and frequent eligibility determinations, will crumble and fail to become legitimately enrolled. Such an attitude selling people short betrays a paucity of knowledge or understanding about beneficiaries of government transfer programs that is contradicted by experiences in my household for more than two decades regarding dozens of Medicaid-eligible (as well as eligible for many other government transfer programs) employees. Typically, because they are rationale beings, they have in-depth knowledge of exactly what they have to do to retain eligibility and, if their inclinations, how to game the system to receive maximal benefits. In reality, as long as government makes sufficient efforts to inform and streamline initial application and subsequent verification processes, few eligible individuals will miss out who truly want to access these programs.

A corollary to this is that for the ABAWDs not enough employment, schooling, or volunteering opportunities will be available in all places given their family and transportation constraints for all wanting to fulfill the community engagement requirement to do so. Consider, however, that Medicaid never was intended to cover that populations, and that the educational and nonprofit sectors are more than robust enough to increase their supply of services to aid in creating enough coverage opportunities for those who genuinely want access.

The naysayers also bray that providers will close up shop as a result of these reforms, with the most likely imperiled being rural hospitals. Of course, if in fact ineligible or unmotivated individuals no longer show up for services, then it’s a question of too many providers chasing too few genuinely needy eligible people. And insofar as rural hospitals that states presumably keep propped up through the soon-to-be circumscribed provider taxes, in fact research indicates that doesn’t really happen and it’s large, urban hospitals who benefit from provider taxes. Finally, the new law apportions $50 billion in additional spending to support rural hospitals that have left special interests in Louisiana cautiously optimistic about the laws’ impact on these.

But perhaps the biggest winners from the new law will be the most vulnerable serviced by Medicaid, such as Americans with disabilities. Especially in an expansion state like Louisiana where, as the data show, people with disabilities get short shrift with perverse incentives to shovel money at far healthier populations, the new law will help to conserve and send resources to those who really need it.

Unfortunately, aided by a compliant if not collaborative media, lies about the new law will continue to be spread by the likes of Democrat Reps. Troy Carter and Cleo Fields and Democrat state Sen. Sam Jenkins, who once led his party’s caucus in the other chamber. Informed, thinking people need to ignore this electioneering.