Wednesday, May 21, 2025

Sid Salter: Medicaid Spending Centers on Policies that Target Enrollment

 Since the U.S. House of Representatives passed a budget resolution that calls for a $2.3 trillion cut to mandatory spending over the next decade. Republican lawmakers are working to make $880 billion of those cuts in the Medicaid program.

The Congressional Budget Office has established that cuts of that size would necessitate Medicaid program cuts, despite repeated promises from President Trump that he and his cabinet would not cut the program. Trump did say he intends to cut “fraud” and waste from the program.
 
House Democrats believe that a Medicaid cut of $2.3 trillion, or about a third of projected Medicaid spending. Medicaid is a joint federal-state program that covers medical costs for the poor, the blind, people with disabilities, the elderly, and children. House Republicans say their counterparts across the aisle are engaging fear fear-mongering and political grandstanding as the word “Medicaid” is not mentioned in the budget resolution.
 
Democrats claim Medicaid in Mississippi covers more than 640,000 Mississippians, or over 25% of the state’s total population. Further, they claim a congressional cut of one-third of federal Medicaid funding across all segments could result in 120,000 rural residents and 110,000 children losing their health coverage, as part of a total of over 200,000 people who would be left without Medicaid coverage. As many as 1-in-4 senior citizens could lose their nursing home care.
 
Mississippi remains one of 10 states that have not adopted some form of Medicaid expansion or so-called “Obamacare” to draw down additional federal funds to pay for health care for the working poor.
 
The 10 non-expansion states include Alabama, Florida, Georgia, Kansas, Mississippi, South Carolina, Tennessee, Texas, Wisconsin, and Wyoming. The failed 2024 Mississippi Medicaid expansion effort would have expanded Medicaid coverage to about 200,000 people who earned up to 138% of the federal poverty level, or $20,120 annually for one person.
 
The decision not to expand Medicaid has left an estimated 166,600 uninsured non-elderly adults in the state ineligible for Medicaid coverage under the Affordable Care Act standard.
 
Like the two major parties in Congress, advocacy groups are likewise split on the issue depending on their political or policy leanings. The liberal Brookings Institution holds that Medicaid cuts are dictated by the GOP-backed proposal. “Estimates suggest that achieving the dramatic spending reductions Congress is aiming for in reconciliation will require cuts to Medicaid, which serves lower-income adults and children through a combination of state and federal funding.
 
“Two types of potential cuts—lowering the federal matching rate for the Affordable Care Act Medicaid Expansion and implementing work requirements—would be especially harmful to 50–64-year-olds, who are less likely to be able to work and more likely to have existing or emerging health issues. Evidence from the states and other programs suggests that work requirements would significantly reduce insurance enrollment without boosting employment, and these impacts are likely to be larger for this population,” Brookings concluded.
 
The conservative Heritage Foundation saw it from a different perspective: “During the COVID-19 pandemic, Medicaid had a significant surge in enrollment. Due to restrictions on the states preventing them from verifying eligibility during the pandemic, total enrollment jumped from 70 million in February 2020 to a high of 94 million in April 2023.
 
“Allow work requirements as a condition of receiving benefits. Like in other welfare programs, certain able-bodied Medicaid enrollees should be required to work or look for work as a condition of receiving benefits. The first Trump Administration approved several state proposals to put in place a work requirement. The Biden Administration rescinded those agreements. The second Trump Administration should revive those efforts, and Congress should follow with additional statutory changes and guidance.”
While disagreements between the state House and Senate are present, it’s unlikely the Mississippi Legislature will make any significant changes to the existing Medicaid program until President Trump brings more clarity to his stance on Medicaid and until Congress acts on the legislation.
 
In a relatively poor state like Mississippi, Medicaid remains too volatile a program for missteps by state leaders.

Sid Salter is a syndicated columnist. Contact him at sidsalter@sidsalter.com.
 

27 comments:

Anonymous said...

Why should I be forced to pay taxes to pay for others healthcare? No one helps me pay for my health care!

Anonymous said...

I lived in Florida during 9/11. I worked for a contractor and all of our jobs were on military bases. After the attacks, we weren't allowed on base for quite some time and my company had to lay off employees. Due to this, we ended up on Medicaid. It was there for us. We needed it. We eventually moved back to Mississippi to be supported by family until we could find work. We had to reapply for Medicaid here. We were on it for a year.
The difference in Florida, we had to re-apply every quarter to qualify. We had to sit down with a case worker and go over our need and present documents.
Contrast that with Mississippi, you only have to apply annually. The case workers don't really seem to care and getting on it was easy.
An update to this process would eliminate the grifters and save Mississippi a lot of money. Don't expect our state legislature to try to adjust this process. They don't really care. They prefer to cry instead of find solutions.

Anonymous said...

Who cares, tell them to get a job and get health insurance like the rest if us.

Anonymous said...

Why do we need Medicaid now that we have Obamacare and medical marijuana?

Anonymous said...

Why should I be forced to pay taxes for farmers who need bail outs? No one pays subsidies for my business. Why should I be forced to pay taxes for corporate welfare and bail outs? No one helps me pay for my business during tough times. Why should I be forced to pay taxes for auto company bail outs? No helps me pay for my business?

Anonymous said...

Schumer, Salter and other Socialists will never favor work or job-search requirements for the able-bodied who are typically disinclined to work.

Democrats depend on the 'wagon riders' in order to stay in office. If work is required, why would the able-bodied need the democrat party?

Anonymous said...

My wife and I both work full time with three children below the age of 10. We qualify for no government handouts. We can't afford health insurance so we save up and pay cash. Pro tip: you must negotiate on all bills. Why should folks not working get health insurance? It doesn't seem fair.

Anonymous said...

I think you should be able to apply and receive benefits via an email or phone call. There is no fraud to be found in this system. It's all good.

Anonymous said...

Mississippi has missed out on a significant amount of money by not expanding Medicaid. The benefits of expansion outweighed the negatives other than an issue of pride by state leaders. Our state has never turned down federal money for any issue other than expanding Medicaid but our leaders chose to die on that hill.

Federal Medicaid cuts will be difficult to come by because there are Republicans who represent districts with large enrollments who fear for their jobs.

Are there lazy people on Medicaid who are cheating the system? Yes. Are there lazy people on disability who have cheated the system? Yes. There is no program anywhere that doesn't contain abuse or fraud. That does not make the program bad.

Anonymous said...

Healthcare in the most prosperous nation in the world should be considered a human right, as it is in the rest of the world. If we had universal healthcare we could actually save money by cutting out the middlemen and give people better service. Americans pay way more for healthcare as a percentage of our GDP than any other 1st world country with only average outcomes.

Anonymous said...

Universal healthcare, sounds good. In a country in which half the populace is obese, however, with the attendant comorbidities obesity carries, the costs would quickly rival defense spending in size. I’ll support universal healthcare when that segment of the population who won’t work toward living healthy becomes fit and eats right, like I do. Until that day, they deserve nothing.

Anonymous said...

@9:42 AM

I am currently living in a country free universal healthcare.
Only the poor use the government hospitals because you literally have to show up at 8:00 AM, take a number, and wait until nearly 2:00PM in the afternoon to be seen. Only the poor and unemployed could tolerate wasting that much time

Meanwhile, those who are employed with private insurance, or expats like me who can afford to pay out of pocket, go to the private hospitals and wait about an hour.

Krusatyr said...

Thank you 10:23 for a realistic look at "Free Healthcare" horrors. Refreshing to hear the truth as opposed to the socialists who give their limp wristed, milque toast leftist wet dream of Medicaid Expansion.

Anonymous said...

Regarding the "surge" in Medicaid enrollment during the COVID 19 pandemic, we now know that many people lost their jobs unecessarily due to government shutdowns and restrictions on businesses and restaurants. All that has now been shown to have been ineffectual and done entirely at the behest of government pundits. These pundits lied, and before a congressional hearing admitted to such. So if Medicaid got raided, let's allow some of the blame to go where it should rightly be.

Anonymous said...

Yep, but I think you meant "bureaucrat," not "pundit."

Anonymous said...

Salter & the Brookings Insitute SPECULATE regarding the ability of the 50 to 64 year old segment of society's ability to work. I have heard no one propose unilaterally, without review, suggest this segment be prohibited from consideration for Medicaid benefits.

Anonymous said...

My problem is with May 21, 2025 at 8:52 AM-B. Not what the poster said, but with the fact both husband, and wife, worked, but couldn't afford health insurance. There's something really wrong with that picture. If anyone should qualify for Medicaid, those families should.

Anonymous said...

Ok then you can donate your money but don’t force the rest of us to pay someone else health care

Anonymous said...

@ 8:52 EITC Earned Income tax credit it’s not earned at all but is a handout, did you miss that on your taxes?

paulo said...

The sad part is that cuts to Medicaid will result in higher cost and poor quality care for everyone. Even people with top line private coverage.

Anonymous said...

@ 2:44 they may not be that poor. Suppose they bring in $120k wages, so $95k after taxes with three kids. Can they spend $22k annually on health insurance? They still have to pay deductibles and copays and what not.

Anonymous said...

Good Lord, if you can't afford to provide for your freaking children then you shouldn't be having them - and that's at any level of income. People have know that since Jesus was in foster care.

Anonymous said...

"The sad part is that cuts to Medicaid will result in higher cost and poor quality care for everyone."

How you be comin' up with that, Paulo? Be specific.

Anonymous said...

The exact number is closer to 667,00 and about 52% ( about 347,000) are children. So, those kids will either die or add to the number of disabled adults.
Sometimes it's good to actually know about the structure, and function of the programs you cut. Or you can do it willy nilly and live with bad outcomes like putting more stress later on the medical delivery system.

Anonymous said...

May 21, 2025 at 4:22 PM, under the scenario laid out, they were providing for the children. It was funds for health insurance that was lacking. But, I suppose a tight wad like you, that didn't know Jesus wasn't in foster care, would begrudge them health care. Shame on you.

Anonymous said...

Your taxes aren't paying for other's healthcare. Your taxes are going towards the national debt.

Anonymous said...

For the umpteenth time y'all....healthcare is NOT a right like so many wish to frame it as. One must carefully plan their lives (and guide their children to do the same) and part of planning is how you're going afford healthcare....not different the expenditures for anything else. Those who fail to plan for their (and their children's) healthcare, plan to wrongly complain about something or someone else not providing them healthcare. Grow the hell up people.


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