Latest Hit Piece Shows Bias Of The Welfare-Industrial Complex

The media never fail to amaze. Even after decades in Washington, one remains astounded at the ways in which they contort reality to meet their ideological narrative.

That’s the takeaway from a recent article outlining one element of last year’s budget reconciliation law. The story blamed President Trump for implementing a law passed by Congress, and bemoaned the fact that states might not get to use the Medicaid program to engage in more questionable cash grabs from the federal government.

Waiver Approval Process

Congress enacted the provision in question in Section 71118 of last year’s budget reconciliation law. Simply put, the provision requires all states seeking approval or renewal of Medicaid waivers — which currently encompass roughly one-third of Medicaid spending — to receive a certification from the Medicare actuary that their waiver will not increase federal spending.

On this matter, I will readily declare my biases. Having publicly suggested this provision the week after the November 2024 election as a reform Congress could enact, I supported it from the get-go and believe it will yield good policy. By contrast, Phil Galewitz, the reporter for KFF (formerly the Kaiser Family Foundation) Health News, evidently opposes the measure — but won’t come out and say so outright.

He starts by naming Trump no fewer than nine separate times in the article itself, not to mention the headline: “Trump Team’s Use of Arcane Budget Rule Threatens Medicaid Coverage.” Even though the provision at issue was passed by Congress, the article refers to “Trump’s signature tax-and-spending law,” and “Trump’s law.” The framing seems particularly ironic: for all the left’s talk about Trump riding roughshod over Congress and threatening democracy, they sure seem willing to overlook Congress’ role in enacting legislation — that is, when they believe it suits their ideological purposes.

Likewise, the article implied that the administration recently concocted some dastardly plot to upend the Medicaid program:

Pivoting from the long-standing practice of checking only retroactively whether states were keeping their budget promises, the Trump administration said in June that it would not renew or approve any waivers unless the CMS [Centers for Medicare and Medicaid Services] first certifies that they would not increase costs to the federal government.

Except this supposed “pivot” was made to comply with the law. Section 71118 is clear: “Beginning January 1 2027, the Secretary may not approve an application for (or renewal or amendment of)” a Medicaid waiver without a certification of budget neutrality from the actuary. Again, it’s funny how the same people accusing the Trump administration of running a would-be dictatorship attack it for upholding the law — just because this law happens to offend the welfare-industrial complex.

Stop Overspending

The article quotes various experts raising doomsday scenarios about both the legislative provision and the administration’s interpretation of it:

• “What we have here is a sneaky way to cut Medicaid expansion and the Medicaid program.”
• States will have to clear more bureaucratic hurdles.… That could lead to fewer benefits or reduce the number of people eligible for Medicaid.
• Many long-standing waivers that have been renewed multiple times are now at risk and … the loss of state waivers could threaten money hospitals rely on to cover uninsured patients and improve care in their communities.

But as I previously noted, these types of waivers have been ripe for abuse and politicization. In 2014, the Government Accountability Office concluded that federal officials approved $778 million in excess spending for an Arkansas Medicaid waiver — the Obama administration essentially using additional taxpayer dollars to bribe Arkansas into expanding Medicaid under Obamacare. (In 2024, I also proposed requiring budget-neutrality for Medicare waivers — so as to prevent a reprise of the Biden administration’s bailout of insurers offering Medicare prescription drug coverage — but Congress sadly has not yet enacted it.) The KFF article does mention this fact — but not until its 25^th paragraph.

To their credit, Arkansas Medicaid officials in the administration of Republican Gov. Sarah Huckabee Sanders are trying to clean up the mess left by then-Gov. Mike Beebe, D-Ark., when he and the Arkansas legislature accepted the federal bailout to expand Obamacare. Arkansas officials are working to modify the Medicaid waiver to ensure it doesn’t cost the federal government additional money.

But the other experts quoted in Galewitz’s article — to say nothing of blue states that will face the same dilemma Arkansas does as their Medicaid waivers come up for renewal — are making a disingenuous argument. All their talk about “cuts” and added burdens ignores the fact that state Medicaid programs never should have received additional federal dollars like the extra money awarded to Arkansas in the first place. Obsessing about the former to the exclusion of the latter amounts to a blunt, albeit tacit, admission: “We stole that money fair and square!”

I explained last year how think tanks like KFF don’t really care about fraud, so long as that fraud results in more people obtaining “coverage.” The recent story amounts to a reprise of the genre: it matters little that states are bilking the federal government for money they don’t deserve, so long as that money goes toward supporting the welfare state. The taxpayers footing the bill for this additional, unjustified spending might beg to differ.