Thanks Largely to Expansion, Medicaid Fraud Likely to Exceed $75 Billion | Eastern NC Now

Publisher's note: This post, by Brian Balfour, was originally published in Civitas's online edition.

    "Twenty percent or more of Medicaid spending in 2019-an amount likely to exceed $75 billion-is improper. Before ObamaCare, the Medicaid improper-payment rate was 6%."

    That's the findings of an analysis of a Centers for Medicare and Medicaid Services report published in the Wall Street Journal earlier this week (subscription required).

    Authors Brian Blase and Aaron Yelowitz, a former special assistant to President Trump at the National Economic Council and an economics professor at the University of Kentucky, respectively, examined the CMS data and concluded "Medicaid's improper-spending problem is large and growing."

    Indeed, they estimate "that between 2.3 million and 3.3 million people with income above eligibility thresholds-and who would not be eligible for Medicaid for another reason like pregnancy or disability-are enrolled in Medicaid in expansion states."

    Why such a significant rate of benefits flowing to ineligible people?

    "In 2014 when the expansion started, the feds stopped doing audits of states' Medicaid eligibility determinations," the authors note. "The Obama administration's goal was to build public support for the new law by signing up as many people as possible."

    The Obama administration didn't want to let a minor detail like legal eligibility for the program get in the way of ginning up public support for his signature program - taxpayers be damned.

    Now that the CMS is able to audit the program again - now that Obama is safely out of office, we might add - they are finding alarming rates of improper payments.

    And because expansion enrollees are covered by federal dollars at a higher rate than traditional Medicaid populations, "states view (ed) the Medicaid expansion as a cash cow," the authors observed, leading expansion states to "generally fail(ed) to conduct proper eligibility reviews."

    This helps to further explain why expansion states so consistently saw enrollment rates far higher than projections.

    What a disgusting shame that the Obama administration would intentionally turn a blind eye to massive fraud in an attempt to score political points.

    We can add this to the already very lengthy list of reasons why North Carolina should continue to fight against Medicaid expansion.