photo #8219497

ANN KENEVAN on May 2, 2025

110 views

In Album: ANN KENEVAN's Timeline Photos

Dimension: 827 x 1081

File Size: 110 Kb

View More View Less

Be the first person to like this.

ANN KENEVAN

SAVINGS TO MEDICAID DON’T NEED TO BE FOUND, THEY JUST NEED TO BE IMPLEMENTED GAO has already identified hundreds of billions in potential savings through waste, fraud, abuse and duplicative payments. OpenTheBooks Apr 02, 2025... View MoreSAVINGS TO MEDICAID DON’T NEED TO BE FOUND, THEY JUST NEED TO BE IMPLEMENTED GAO has already identified hundreds of billions in potential savings through waste, fraud, abuse and duplicative payments. OpenTheBooks Apr 02, 2025 A political dogfight has broken out about funding for Medicaid in the wake of President Trump’s direction to free up $880 billion in savings to fund his agenda. It’s the return of the perennial “they want to throw grandma over a cliff” claim. But the truth is, finding savings in Medicaid, one of the most wasteful and abused federal programs, to make sure the program can serve those who are truly needy, shouldn’t be a tall order. Since the Affordable Care Act (Obamacare), Medicaid has grown far beyond its initial purpose to include able-bodied adults of working age; it’s subject to state-level schemes aimed at sapping more federal funds; and the federal government’s own auditor, the Government Accountability Office (GAO) says it’s filled with potential savings. Indeed, House Speaker Mike Johnson said last month that the people most in need of the government’s health coverage would continue to have it. Instead, the savings would come by targeting waste, fraud and abuse rife throughout the program – to the tune of about “$50 billion a year in fraud alone,” he said. While that figure is not quite accurate, taking aim at that type of spending is exactly what Republicans and Democrats can do to spare Medicaid from fiscal oblivion. They simply must identify savings to make the social safety net solvent without continuing to crush taxpayers with debt. Unfortunately, it’s a refrain we’ve heard for decades already. Because it represents a “Third Rail” of American politics, politicians are only willing to mention fixes for “waste, fraud and abuse.” But the details never seem to emerge in the media, nor do the fixes get implemented. By eliminating the waste, fraud and abuse from both Medicaid and Medicare – and doing a better job tackling improper payments across government – it’s possible to net $880 billion in savings over a decade. But it will take an unprecedented new willingness from Congress to actually do the hard work. Elected officials don’t lack for ideas – the GAO supplies them on a routine, annual basis when it releases a report on potential improvements to mitigate or eliminate waste, duplication and inefficiency. Implementing them would go a long way toward solving the coming crisis of solvency at the Centers for Medicare and Medicaid Services (CMS), while also freeing up the funds needed to implement Trump’s agenda. Let’s take a look at just a few of the angles Congress, CMS (and other executive agencies) can take to find huge savings. IMPROPER PAYMENTS TO THE TUNE OF TRILLIONS The Centers for Medicare and Medicaid Services have been the largest contributors to improper payments across the federal government in recent years. Over the past decade, CMS has made over $1 trillion in improper payments – the wrong payment to the wrong person or entity, for the wrong amount or the wrong reason. That’s more than half of the $1.9 trillion in improper payments made by all executive branch agencies. Payments were made in error because there was insufficient documentation to determine the eligibility of applicants; because the information that was needed didn’t exist; or because that information wasn’t able to be accessed, or the employee failed to access it. In other cases, bureaucrats failed to follow the relevant statute or regulation. States and individual vendors often didn’t have or didn’t send sufficient documentation to the federal agency from which they were receiving funding. Open the Books reported last month that President Joe Biden had the dishonorable distinction of overseeing $925 billion worth of improper payments during his four years as chief executive. Add in the $673 billion in improper payments during President Donald Trump’s first term, and you have $1.6 trillion in possible savings over eight years — almost double the amount Trump is asking Congress to save from Medicaid, without explicitly saying the name of the entitlement program. If even half of those improper payments were prevented, the Trump agenda could be fully funded. MEDICAID FRAUD Fraud doesn’t happen solely through people gaming the system, and mismanagement doesn’t happen only because of bureaucratic bungling. States can improperly benefit by effectively laundering federal funds, a scenario detailed by Paul Winfree, Ph.D., founder, president and CEO of Economic Policy Innovation Center; and Brian Blase, president of Paragon Health Institute. Their new report, “California’s Insurance Tax Shuffle: How Federal Money Ends Up Paying for Medicaid for Illegal Immigrants,” paints the picture. The practice involves increasing taxes on Medicaid insurers, which necessitates an equal payment from the state of California. California can then invoice the feds, who match 60% of their Medicaid spending. That added revenue can go toward paying for care for more people – in this example, it’s illegal immigrants – and the balance can go to the general fund for use on other spending priorities. “California launders federal funds through a tax on Medicaid insurance plans to cover illegal immigrants,” Winfree said in a post on X. “While the feds covers 50% of Medicaid for the disabled & pregnant in California, they pay 100% for illegal immigrants.” https://openthebooks.substack.com/p/savings-to-medicaid-dont-need-to

View Less

SAVINGS TO MEDICAID DON’T NEED TO BE FOUND, THEY JUST NEED TO BE IMPLEMENTED openthebooks.substack.com

May 2, 2025