By Brian Blase & Hayden Dublois
National Review, December 9, 2020
A recent report from the Centers for Medicare and Medicaid Services (CMS) reveals astronomical improper spending in Medicaid that should alarm all Americans.
The rate of improper payment in Medicaid, the nation’s third largest government program, now exceeds 25 percent, meaning that more than one in every four dollars spent in the Medicaid program—or more than $100 billion in federal spending each year—is in violation of program rules.
It turns out that millions of Medicaid enrollees are ineligible for the program, in most cases because they earn too much income but in others because they are not lawful residents. The media, to date, have virtually ignored the issue.
The CMS report finds that much of the improper spending is because states do not properly verify that recipients are actually eligible for Medicaid. In many instances, states ignore federal requirements and do not check applicants’ incomes, nor do they conduct regular reviews to ensure that those on the program continue to meet other eligibility rules. People qualify for Medicaid largely on the basis of income so failing to verify a Medicaid applicant’s income is like failing to check a Medicare applicant’s age. Past audits confirm that eligibility errors account for more than six in ten improper payments.
Taxpayers are being fleeced, and we can’t fix the problem until people know and understand what’s happening. We should all be able to agree that program rules should be followed and only those eligible to receive benefits should be enrolled in the program. When income isn’t verified or eligibility isn’t properly redetermined, it can’t be dismissed as just a procedural hang-up. Enrolling the right people is one of the most important and basic roles of government management of programs.