Ambulances at a hospital in San Diego
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K.C. Alfred/Zuma Press
Both parties in Congress appear to have given up on enacting healthcare policy changes through regular order—i.e., committee hearings, debate and up-or-down floor votes. That explains the omnibus spending bill’s mish-mosh of healthcare measures, and please don’t call them reform.
One of the few positive provisions is a phase-out of the 6.2 percentage-point Medicaid payment bump to states under a March 2020 law that prevented states from removing ineligible enrollees during the public-health emergency. The Medicaid bump will start to phase out in April whether or not the Administration ends the emergency.
Medicaid rolls have swelled during the pandemic by some 24 million to 98 million, and nearly one in three Americans is now on the program. If not for the emergency, most of these new beneficiaries would be removed because their income exceeds state limits or for other reasons such as they haven’t complied with modest cost-sharing rules.
The Foundation for Government Accountability says the monthly cost of ineligible enrollees is $15.2 billion, $11.4 billion of which is picked up by the feds. But states’ $4.8 billion share now exceeds the $2.9 billion they receive in extra federal Medicaid funds each month.
The emergency should have ended long ago, but public-health outfits warned the uninsured rate would balloon. But the Inflation Reduction Act extended sweetened ObamaCare subsidies through 2025. So culling the Medicaid rolls ironically may increase federal spending since many who are booted will qualify for those more generous subsidies.
In return for this faux concession, Democrats extracted an expansion in benefits, including postpartum Medicaid coverage and Medicare coverage to include . . . marriage therapy. How much will these entitlement expansions cost? Who knows? The Congressional Budget Office hasn’t released a detailed score of the bill. States will continue to…
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