When I observe the pushback from politicians and interest groups against Medicaid reform, I can’t help but ponder their reasoning.
Medicaid is a massive program, costing around $914 billion annually. In 2024 alone, Americans contributed $584 billion through federal taxes and $326 billion via state taxes to support it, which also covers the Children’s Health Insurance Program. Interestingly, this total has risen from $616 billion in 2018.
Over six years, Medicaid expenditures have surged by 48%. It’s now one of the largest mandatory spending programs, comprising 9% of the federal budget—surpassing the entire defense budget.
Moreover, polls indicate that 58% of Americans believe there’s enough waste in federal spending to balance the budget without raising taxes, yet politicians argue against reforming this nearly $1 trillion program.
Interestingly, some elected officials resist changes aimed at reducing payments to illegal immigrants, fraudsters, and able-bodied adults who choose not to work.
Take, for instance, the proposed budget plan in the House that aims to make significant reforms to Medicaid. The plan suggests saving over $11 billion by halting payments to illegal immigrants. Would serious politicians really want to return home and justify that kind of expenditure?
Additionally, it proposes saving nearly $29 billion by requiring able adults to work to qualify for Medicaid. How can politicians explain to hardworking constituents that their taxes are being used to subsidize individuals who do not seek employment?
There are also measures targeting the elimination of Medicaid fraud, projected to save approximately $245 billion. Who is willing to defend such a staggering amount lost to fraud?
These three reform areas could, collectively, save taxpayers around $545 billion without compromising legitimate beneficiaries.
Yet, some politicians argue that these clear financial benefits amount to cuts, misleadingly claiming that reforms could harm those who genuinely rely on Medicaid.
This narrative, though, doesn’t seem to hold up with public sentiment.
In a recent initiative, Americans expressed their views on these crucial Medicaid reforms. The results show that 62% disapprove of allowing states to allocate taxpayer money for Medicaid services to illegal immigrants. Notably, this includes 75% of Republicans, 66% of independents, and 47% of Democrats. It seems illogical for elected Republicans to oppose restricting Medicaid benefits for illegal immigrants.
Additionally, there’s widespread support—62%—for federal laws that would prohibit such expenditures. The public is quite firm on not wanting taxpayer dollars used this way.
There’s also increasing desire to combat Medicaid fraud and waste. In fact, 68% of voters feel strongly about preventing individuals who refuse to work from receiving taxpayer-funded benefits.
Even amidst differing opinions, support for work requirements across safety net programs remains robust. A whopping 78% of voters endorse job requirements for healthy adults receiving federal benefits. Remarkably, even among current Medicaid recipients, 66% agree with this notion. Among recent welfare recipients, 70% are on board as well. It’s noteworthy that when we see broad support across party lines—like 89% of Republicans and 75% of independents—one would think such measures would soon become law.
The overwhelming backing for job requirements is reminiscent of the 1996 Welfare Reform Bill, which garnered bipartisan support, with many Democrats standing in favor.
So, the next time politicians claim Medicaid reform is unfeasible, perhaps we should ask whether they really want to fund benefits for illegal immigrants, fraudsters, and able-bodied adults unwilling to work. If their answer is yes, maybe they should reconsider their positions in the next election. If they’re against it, then they need to stop insisting that Medicaid reform is impossible.
This is a critical moment. We need to move away from the burdensome financial paths that lead to untenable deficits and crippling debt payments. Otherwise, we may face both financial and moral crises.
Advancing Republican Medicaid reforms and securing $545 billion in savings is pivotal to fostering a brighter future for America and ultimately achieving a balanced budget.
Let your legislators know that you support a sustainable future for Medicaid and essential reforms.
