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Make Medicaid Great Again
Democrats are poor in virtue, but rich in craftiness. They always are up to something, and almost always no good.
Since President Donald J. Trump’s inauguration, Democrats relentlessly have screeched, “Republicans want to cut Medicaid! Republicans want to cut Medicaid!” Their desperate screams have made Chicken Little’s warnings of a collapsing sky sound as startling as a train schedule.
Baffled Republicans looked at each other, shrugged, and explained that no one in the GOP called for cutting Medicaid. “We’re not going to touch it,” Trump said in February.
Through their sincere denials, Republicans unwittingly painted themselves into a corner. As they prepare the Big, Beautiful Bill, complete with Trump/GOP tax cuts and other free-market measures, some Republicans want to Make Medicaid Great Again. They aim to return this entitlement to its roots as a slim program, focused on the truly needy, rather than today’s morbidly obese boondoggle, which, as of December, covered 71.3 million Americans, or 21 percent of this country’s 340 million men, women, and children.
Can Republicans escape this corner without covering the political landscape with paint-colored footprints? Actual Medicaid-spending reductions would give Democrats a huge rhetorical triumph. The last thing Republicans need is every Democrat in America hollering: “We told you so! We told you so!” This would give the Left precisely the self-justifying endorphin rush to escape their doldrums and act like a respectable opposition party — a duty for which these politically violent cultural Marxists are categorically unqualified.
Republicans can reform Medicaid without actually slicing below today’s spending levels. Necessary and sensible steps would limit this program’s future growth — dramatically but without an actual Democrat-rescuing cut, per se.
First, boot every illegal alien from Medicaid. Illegal aliens who invaded America, with neither permission nor papers, have no rights, other than to turn around and get the hell out of this country. Congress and President Lyndon Baines Johnson enacted Medicaid in July 1965, to heal pregnant women, poor children, low-income seniors, and the disabled. They did not do so to nurse those who broke into America. If Democrats want to argue that Americans’ hard-earned tax dollars should treat foreign invaders rather than U.S. citizens and legal immigrants, Republicans should give Democrats free microphones to deliver such speeches.
The Naples, Florida-based Foundation for Government Accountability produces superb policy analyses, in real time, on Medicaid reform. Many of its findings and data appear in this opinion piece.
FGA found that, under Joe Biden’s wide-open border, Medicaid outlays for illegal aliens swelled 75 percent between 2020 and 2024. In just 18 states, this cost taxpayers an extra $16.2 billion.
Illegal aliens may receive Medicaid benefits for 90 days, while state officials check their immigration status. Corrupt Democrats have abused this rule by letting illegals reapply as those 90-day intervals lapse. In some states, illegals have remained on Medicaid for 14 years, by renewing their quarterly benefits 56 times!
Last year, Biden issued a new regulation that prevented states from capping these 90-day renewals. In essence, illegal aliens can remain on Medicaid until further notice. FGA reckons that closing this loophole would save taxpayers $5 billion.
A broader effort to verify that Medicaid recipients actually are eligible for benefits could save up to $282 billion. A stunning 78 percent of voters support this idea. Equally stunning and far more stupid: An Obama-era regulation keeps eligibility checks, at most, annual.
Second, battle Medicaid fraud. The U.S. Government Accountability Office (GAO not FGA) reported last month that improper Medicaid payments in Fiscal Year 2024 totaled $31.1 billion, or $311 billion over a decade. Some of this impropriety might concern an inaccurate procedure code here or a missing doctor’s signature there. But if even 10 percent of this sum involves fake patients getting phony treatments in imaginary clinics, the counterfeit doctors should be in handcuffs, and taxpayers should recover $3.1 billion every year.
Third, able-bodied adults without small children should work, train, or volunteer in exchange for Medicaid. Currently, 62 percent of in-shape adults on Medicaid do not work, and 85 percent of new enrollees over the last 10 years did equally little. As the economy accelerates, physically fit beneficiaries will score full-time jobs, slide off of Medicaid, and the program’s cost will drop. This will liberate resources for the bedridden, chronically ill, elderly, and feeble who need help, unlike robust men and women on Medicaid who prefer to watch Netflix and take naps. Among voters, 73 percent favor this idea, which could save up to $287 billion.
Work requirements will make Democrats squeal like suckling pigs wedged between barn doors. Republicans should tell them to simmer down and savor the words of far-Right extremist Joe Biden.
“Since 1987, when I first proposed an overhaul of the welfare system, I have argued that welfare recipients should be required to work,” then-Sen. Biden said in 1996. “I was pilloried by many of my friends back then for even suggesting the idea of requiring work. Today, I think everyone here believes that work should be the premise of our welfare system.”
Fourth, ObamaCare’s absurd funding formula pays states 57 percent of the cost for truly needy Medicaid recipients, but it covers 90 percent for able-bodied enrollees. Grandfathering current beneficiaries and ditching the 90 percent subsidy for new aid recipients would save $219 billion and cut nothing from anyone now on Medicaid. This idea earns cheers from 78 percent of voters.
Finally, consider Most Favored Nation. This glamorous name camouflages a dreadful idea that the GOP should scorn.
Some bamboozled Republicans are considering infecting the Big, Beautiful Bill with a Socialist-Price Scheme for pharmaceuticals. They want America to import the artificially low drug prices set by foreign governments, such as the $1,000 that the British National Health Service pays for each injection of Eyelea, a treatment for age-related macular degeneration. In America, that same dose lists at $1,850. Likewise, in 2019, the NHS coughed up a paltry $170 per shot of Humira, the revolutionary arthritis drug. U.S. cost: around $3,000.
British and European prices reflect the Soviet-style, “take-it-or-leave-it” power that these government-run health systems use to shake down U.S. drug companies. Americans, meanwhile, often enjoy steep discounts that insurers negotiate.
Big Government intervention lets overseas consumers enjoy cheap drugs while sticking U.S. patients and taxpayers with higher prices to offset consequent foreign losses. This is the global equivalent of a Walgreens cashier charging double to compensate for the mostly peaceful looters who swiped half the drug store’s inventory.
Republicans should reject this demented Socialist Price scam and, instead, prescribe an America First cure to this pharmakleptomania. This would shift the unfair share of drug prices from U.S. patients, back where it belongs: Make socialist medical monopolies pay their fair share for the fruits of U.S. pharmaceutical laboratories. If they want American drugs, pay American prices.
Deroy Murdock is a Manhattan-based Fox News Contributor.
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