Opinion

Medicaid Waste, Fraud, And Abuse Must End

President Trump campaigned on a broad pledge to reduce the size of government, to combat the pervasive waste, fraud, and abuse of American tax dollars, and to improve efficiency.

In less than three months in office, he has already delivered in ways that have exceeded the expectations of any reasonable person. And Americans, by large majorities, approve of these efforts.
Medicaid, the government healthcare program for disabled and low-income Americans, is now getting a much-needed review as Congress begins its work finding cost-saving opportunities to reduce spending.
Members of Congress are wisely following President Trump’s guidance that they should focus on eliminating the waste, fraud, and abuse that is rampant within the payment system. Americans are supportive of this effort, as evidenced by the Paragon Health Institute’s new poll results, published just last month. The survey reveals strong majority support for a host of reforms to federal health insurance programs.

For instance, by 66-34%, respondents agreed that “Congress needs to take a hard look at all federal health care programs to ensure they are spending taxpayer dollars wisely. Let’s make certain these programs are directing resources to those who truly need help, not enriching special interests that exploit a flawed health care system.”

By 64-36%, respondents agreed that “The government has a responsibility to taxpayers as well as legitimate Medicaid recipients to ensure that only those who are eligible can enroll in Medicaid, even if that means some Americans are left without health insurance coverage.”

Asked, “Do you support or oppose Congress lowering the percentage that the federal government pays states for Medicaid costs for able-bodied, working-age adults to the same level it pays for pregnant women, children, and those with disabilities?”, 64% said they strongly or somewhat support it, while 36% said they somewhat or strongly oppose it.

When asked, “Do you support or oppose allowing states to implement a work requirement for able-bodied adult Medicaid recipients in their state?”, 84% said they strongly or somewhat support it, while just 16% said they strongly or somewhat oppose it.

And 58% of respondents agreed that “It is wrong for the federal government to pay so much more for able-bodied adults than traditional Medicaid recipients like pregnant women, children, and the disabled. It has made it harder for the most vulnerable people to access care, has increased costs, and led to more fraud in the program. The federal reimbursement rate for able-bodied adults should be reduced to the same level as traditional recipients.”

Medicaid has long been plagued with abuses and fraud, committed both by medical providers and by recipients. As just a few examples, providers sometimes bill for services that were never provided. These false claims for treatments or procedures that the doctor never actually provided are a prime example of fraud. Other examples include double billing and unbundling, which is the practice of billing separately for procedures that ought to be billed together with a “bundled code” at a reduced rate. A large area of fraud concerns medically unnecessary services, when medical providers offer services that were unnecessary to begin with and then send off the bill for reimbursement by the government.

In each instance of fraud, taxpayers are left holding the bill. And there is no appetite among Americans for this type of inefficiency and abuse of the system.

President Trump has said that he hopes we can “cherish” and “love” Medicaid, and of course, Americans by wide margins support the idea of providing medical care for those individuals most in need. The physically disabled, seniors living in poverty, children, and single moms are the populations most in need of this program. And it’s precisely for their benefit that Medicaid must be streamlined and preserved.

Waste, fraud, and abuse in Medicaid rob taxpayers, but they also threaten the sustainability of the program, putting vulnerable populations at risk.

Congress has an opportunity in the coming weeks to make significant changes to make the Medicaid program better, by eliminating the abuse in the system. The public supports this initiative, and President Trump is an enthusiastic proponent of this approach. Now is the time for reducing waste, fraud, and abuse in Medicaid to strengthen this essential care for Americans in true need.

Jenny Beth Martin is Honorary Chairman of Tea Party Patriots Action. 

The views and opinions expressed in this commentary are those of the author and do not reflect the official position of the Daily Caller News Foundation.

 

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Jenny Beth Martin

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Jenny Beth Martin

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