by James C. Sherlock
Featured image courtesy of Cato Institute. It is worth a close look by those who suggest there is no room for federal budget reductions.
On the morning of Feb. 25th, I posted a column a week ago that asked whether Virginia should pay the full cost of Medicaid expansion.
That same evening, the budget outline for FY 2026 passed by the House of Representatives on Feb. 25 will need major savings from federal contributions to healthcare. The resolution’s sponsors intend to:
“Achieve $8.7 trillion of savings over 10 years by strengthening Medicare for
seniors, making Medicaid work for the most vulnerable, ending cradle-to-
grave dependence, and lowering interest costs.”
To the charge that the budget resolution will kick poor people off of Medicaid, the sponsors have offered a peremptory response:
Our budget does not include policies that reduce benefits or remove Medicaid enrollees from the program. Rather, the budget refocuses Medicaid on the most vulnerable and empowers states with flexibility so they can tailor their Medicaid programs to their populations.
So that clearly portends state funding of Medicaid expansion.
I quote below the Social Security Act provision on Medicaid appropriations.
“Sec. 1901. [42 U.S.C. 1396] For the purpose of enabling each State, as far as practicable under the conditions in such State, to furnish
(1) medical assistance on behalf of families with dependent children and of aged, blind, or disabled individuals, whose income and resources are insufficient to meet the costs of necessary medical services, (emphasis added) and
(2) rehabilitation and other services to help such families and individuals attain or retain capability for independence or self-care, there is hereby authorized to be appropriated for each fiscal year a sum sufficient to carry out the purposes of this title.
The sums made available under this section shall be used for making payments to States which have submitted, and had approved by the Secretary, State plans for medical assistance.”
It is difficult to square appropriations for Medicaid expansion with that statute.
As pointed out in my previous article, Medicaid expansion alone, unreformed, will cost the federal government $1.7 trillion over the next ten years. Not for basic Medicaid for poor children and adults, but rather for its expansion to cover single, healthy adults earning up to 138% above the poverty level.
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