Are Medicaid cuts heartless? Republicans aren’t villains for right-sizing it after COVID.

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[MM Curator Summary]: There might be a little bit of bias in how the media is reporting on the return to normal operations.


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Perhaps you’ve heard: Republican states are heartless. 

Such is the media narrative on Medicaid as states begin the long-overdue process of removing millions of now ineligible recipients who signed up for the program during the pandemic. The real story is that Republican states are defending taxpayers and the truly vulnerable, while reversing the country’s march toward socialized health care.

Get a few paragraphs into news stories about reductions in the number of people receiving Medicaid, and the villain and victim become clear: Republicans and the less fortunate, respectively.

Yet, this caricature bears no resemblance to reality. Republican-led states are leading the effort to disenroll about 20 million Americans who were ineligible for Medicaid yet couldn’t be removed due to federal mandates during the pandemic.

Pandemic led to huge expansion of the welfare state

That restriction led to one of the biggest welfare expansions in American history, pushing the number of people on Medicaid to more than 100 million for the first time while costing taxpayers at least $16 billion a month.

Despite the Biden administration’s efforts to extend the mandate, the Medicaid expansion expired April 1.


States report having removed at least 4.1 million individuals since then. Texas and Florida have done the most work, right-sizing Medicaid by a combined 900,000 people. Arkansas has removed at least 300,000 people out of an estimated 422,000 who are potentially ineligible, the fastest pace in the nation.

These states are rushing to restore Medicaid to its intended purpose, save taxpayers billions of dollars and preserve resources for the truly needy.

The news media give the impression that ineligible Medicaid recipients are especially vulnerable, but in fact, they generally are ineligible because they make too much money. Many signed up after temporarily losing jobs during pandemic-related shutdowns, but states were unable to remove them for more than three years, even as the economy bounced back and they returned to work.

Biden Medicaid cuts will hurt millions.Democrats need to stop him.

Good options are available for people not eligible for Medicaid

A majority of removed Medicaid enrollees have access to employer-sponsored coverage, federal subsidies on the insurance exchange or other affordable coverage options.

Much of the news coverage focuses on the “procedural reasons” that states are using to remove people from Medicaid rolls. That explanation accounts for about 75% of those who lose Medicaid benefits. The phrase gives the impression that people are kicked off Medicaid on technicalities. In fact, it means enrollees did not establish their eligibility for the program.

Many might have failed to comply with state requests for information because they knew they were ineligible or already had other coverage.

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Some states do deserve criticism. California and New York have removed about 385,000 people from Medicaid, but with up to 2.8 million ineligible enrollees in California and more than 1 million in New York , they’re clearly slow-walking the process.

Blue states are likely waiting for the Biden administration to roll out a new rule that will keep Medicaid broken indefinitely. Last year, the Centers for Medicare and Medicaid Services proposed a mandate that would block states from using commonly used practices to discover ineligible Medicaid recipients.

The transparent goal is to keep them on Medicaid, further eroding the private market and paving the way to socialized health care. The regulation could be made final later this year or early next, before states finish right-sizing Medicaid.

The contempt for taxpayers and the truly vulnerable is astounding. Medicaid is already consuming a bigger and bigger share of state budgets, leaving less funding for critical needs such as public safety and education. Yet, blue states and the Biden administration are content to let this crisis continue. 


This is the essence of socialized health care: Subsidizing subpar coverage for people who can get other health insurance, while leaving less money for the vulnerable people who need Medicaid. The news media is right that someone is heartless, but the culprits aren’t in Republican-led states.

Jonathan Ingram is vice president of policy and research at the Foundation for Government Accountability.


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