The Truth About Medicaid Reform

Medicaid spending is spiraling out of control, threatening state budgets and diverting funds from other critical needs like education and public safety. In Idaho alone, Medicaid expansion costs have nearly tripled from initial projections, reaching $1.36 billion – far beyond the expected $510 million. Similar trends are unfolding across the country.

On a recent episode of At the Core, I examined the urgent need for reform and the challenges lawmakers face. Some of the biggest issues include:

• Lack of work requirements for able-bodied adults
• Massive improper payment rates (some as high as 18.6%)
• Eligibility loopholes that allow ineligible recipients to remain on Medicaid
• Perverse incentives that discourage marriage and work
• Skyrocketing costs that are unsustainable for taxpayers

Conservative legislators are pushing for common-sense reforms such as adding work requirements, improving eligibility verification, removing presumptive eligibility, and implementing stricter payment controls. But these efforts face fierce opposition, including misrepresentation from the media, emotional fearmongering, and even political resistance in red states.

For Medicaid to remain available for the truly needy while protecting taxpayers from financial collapse, reforms are necessary. The question is: will lawmakers have the courage to act?

Walker Wildmon, CEO

AFA Action