06.16.25

Commonsense and Popular Reforms to Preserve and Strengthen Medicaid for Future Generations

Republicans Are Rooting Out Waste, Fraud, and Abuse to Preserve Critical Programs Like Medicaid

“It shouldn’t be available for illegal immigrants. There are people who are ineligible. There are people, able-bodied males who are of working age, there ought to be a work requirement attached to it. These are all reforms to a program that was desperately in need of reform.” – Senate Majority Leader John Thune (R-S.D.)

IN THEIR QUEST TO EXPAND ACCESS TO MEDICAID FOR THOSE WHO ARE NOT ENTITLED TO IT, DEMOCRATS HAVE MADE THE PROGRAM UNSUSTAINABLE

  • “The Biden administration has enacted several major Medicaid rule changes with giant fiscal costs,” including a rule finalized in 2024 that keeps people on Medicaid “when they are no longer eligible,” while restricting the times “when states may verify changes in eligibility.” (Paragon Health Institute: Biden’s Medicaid Changes: High Costs, Misguided Policy – 11/6/24)
  • “Per the Congressional Budget Office, federal outlays on the program have been positively soaring, from $409 billion in 2019 to $615 billion in 2023, and projected to hit $655 billion in 2025. That’s a 50% jump from 2019 to 2023, and 60% to 2025.” (New York Post: Editorial: ‘Deadly’ GOP ‘cuts’ don’t even touch Medicaid’s 50% growth since 2019 – 6/3/25)
  • “Over the last decade, Medicaid has outpaced the growth of the other two largest federal entitlement programs: Social Security and Medicare.” (Cato Institute: Medicaid Is Driving Deficits: Republicans Are Scarcely Tapping the Brakes – 5/13/25)
  • The federal Medicaid program spent $1.1 trillion in improper payments from 2015 to 2024, according to the Paragon Health Institute and the Economic Policy Innovation Center. (Paragon Health Institute: $1.1 Trillion of Federal Medicaid Improper Payments Over Last Decade – 3/5/25)
  • Following Democrats’ expansion, Medicaid enrollment and costs have exploded:

medicaid6_16

(Paragon Health Institute: Medicaid is No Longer for the Poor – accessed 6/15/25)

 

SENATE REPUBLICANS’ RECONCILIATION BILL PUTS MEDICAID ON A MORE FISCALLY STABLE TRAJECTORY SO IT WILL BE THERE FOR AMERICANS WHO NEED IT

  • Republicans’ bill establishes work requirements for able-bodied adults who don’t have dependent children 14 years of age or younger, or a disabled individual in their care. (U.S. Senate Committee on Finance: Chairman Crapo Releases Finance Committee Reconciliation Text – 6/16/25)
  • The bill roots out waste, fraud, and abuse by removing ineligible enrollees and addresses the provider tax, which has ballooned the cost of Medicaid by allowing states to game the system and inflate costs. (U.S. Senate Committee on Finance: Chairman Crapo Releases Finance Committee Reconciliation Text – 6/16/25)
    • “In its final year, the last Administration approved four waivers that exploit this tax loophole, submitted by California, Michigan, Massachusetts, and New York. Together, these four states are responsible for more than 95% of projected federal taxpayer losses under the loophole.”
    • “A CMS estimate shows that if just two more states adopt these schemes each year, excess federal costs could balloon more than $74 billion over 5 years.” (Center for Medicare and Medicaid Services: CMS Moves to Shut Down Medicaid Loophole—Protects Vulnerable Americans, Saves Billions – 5/12/25)
  • Republicans’ reconciliation bill removes noncitizens from Medicaid and addresses the issue of illegal immigrants receiving state Medicaid coverage. (U.S. Senate Committee on Finance: Chairman Crapo Releases Finance Committee Reconciliation Text – 6/16/25)

EVEN BLUE STATES ARE REALIZING PROVIDING BENEFITS TO ILLEGAL IMMIGRANTS IS UNSUSTAINABLE

  • “If this is cruel, then Democrats should also haul up Gavin Newsom and J.B. Pritzker. Those California and Illinois Democrats are seeking to scale back their health coverage for illegals because of ballooning costs, and free health insurance is a welfare magnet.” (The Wall Street Journal: Editorial: The Mediscare Campaign, CBO Version – 6/5/25)
  • Last month, California Gov. Gavin Newsom (D) moved to freeze enrollment of illegal immigrants in the state’s health care program due to budget issues:
    • “Gov. Gavin Newsom… called for California to scale back health care coverage for undocumented immigrants to help balance the state budget, retrenching on his desire to deliver ‘universal health care for all.’” (The New York Times: Newsom Proposes Scaling Back Health Care for Undocumented Immigrants in California – 5/14/25)
    • “Newsom’s plan in his 2025-26 budget has called for freezing enrollment for undocumented adults to receive the full scope of the state’s Medicaid program, known as Medi-Cal.”
      (NBC News: Democratic governors seek to roll back state-funded health care for undocumented immigrants – 6/11/25)
  • “Gov. JB Pritzker’s positioning of Illinois as a sanctuary state, a welcoming port for immigrants from across the globe, hit the hard reality of state budgeting this spring.” (The Associated Press: Illinois mulls ending a health program for some immigrants living in the US illegally – 5/19/25)
    • “[F]acing a budget shortfall for the upcoming fiscal year, Pritzker’s proposed $55.2 billion fiscal plan would cut part of a four-year-old program providing health coverage to some adults regardless of immigration status.” (The Associated Press: Illinois mulls ending a health program for some immigrants living in the US illegally – 5/19/25)
    • “In proposing to end the program, Pritzker noted  the working-age adults that it covers can get jobs with employer-sponsored health benefits.” (Capitol News Illinois: State on track to end health coverage program for immigrant adults – 5/13/25)
    • “However, the two programs have far exceeded their original cost estimates. According to an auditor general’s report released in February, the total cost of both programs from Fiscal Year 2021 through Fiscal Year 2024 was more than $1.6 billion.” (Capitol News Illinois: State on track to end health coverage program for immigrant adults – 5/13/25)