Medicaid Reform Needed to Eliminate Waste and Fraud

Originally published by Morning Call.

Our national health-care safety net, known as Medicaid, is fundamentally broken. It prioritizes the healthy over the sick and insurers over patients—with little accountability. Finally, Congress is taking notice.

Today, Pennsylvania spends about $44 billion in both federal and state funds on Medicaid—more than one-third of the commonwealth’s operating budget. On the federal level, Medicaid—at over $600 billion annually—sits fourth in spending, trailing Social Security, defense, and Medicare.

More important than the scale of the spending is the scale of the waste. Over the past decade, Americans wasted billions on improper Medicaid payments, with national estimates ranging between $543 billion and $1.1 trillion.  The last thorough federal audit of Pennsylvania, conducted in 2019 by the Center for Medicare and Medicaid Services, found $2.3 billion in improper payments, with $1.8 billion due to eligibility errors—about $800 in improper payments per recipient.

But Medicaid’s problems extend beyond this outrageous waste of tax dollars.

Read more at Morning Call.