What exactly is Medicaid? Apparently it is a tangled web of loosely regulated federal assistance programs administered by the states for low-income children and disabled adults.
Along with Medicare, Medicaid was created by the Social Security Amendments of 1965 (Public Law 89-97) as part of the Great Society and War on Poverty of President Lyndon Johnson.
At that time, with the Democrat Party controlling the White House and both Houses of Congress, Medicare and Medicaid were intended to form the Great Society’s comprehensive healthcare plan into the future.
LBJ and the 1965-66 Congressional Democrats allowed Medicare and Medicaid to be governed by an evolving set of complex rules and bureaucratic regulations. Each state was to determine Medicaid eligibility and services.
From the start, a disturbing characteristic of Medicaid was the range in estimated costs. No one had exact figures. Medicaid costs in the late 1960s were estimated at $2.5 billion to $4.7 billion per year. By 1996, costs had jumped to an estimated $8.1 billion; and by 2008, Medicaid estimates reached an unsustainable $299 billion.
Projections are that Medicaid costs in 2012 could range from $387 billion to $700 billion per year.
What has happened? Is the United States experiencing an explosion of medically indigent citizens? No. Truth be known, the mounting increase in Medicaid dollars is the result of a mounting increase in undocumented immigrants.
To further muddy the waters, Social Security Administration (SSA) financial reports lump Medicare and Medicaid together under Public Assistance expenditures, even though Medicare recipients pay for their health insurance in monthly installments subtracted from their wages and/or Social Security checks.
In contrast, Medicaid recipients make no such payments. In addition, Medicare and Medicaid have overlapping services. If the U.S. Congress can’t track Medicare and Medicaid costs, how are citizen-voters to make sense of this bureaucratic web?
Let’s focus on Medicaid. According to a Kaiser Family Foundation report issued in February 2011, estimated federal spending on Medicaid in 2009 was $387 billion. Of this amount, $349 billion went for “Medical Services” (doctor and hospital fees). Unexplainably, another $139 billion went for “administrative” and “other” costs.
In President Barack Obama’s proposed 2012 federal budget, Medicaid costs interestingly remain at the 2009 level of $387 billion, with one major exception —Medical Services” (doctors and hospitals) would no longer be covered in the Medicaid budget. Just how might the proposed $387 billion be spent?
Any attempt to get a handle on 2010-2012 Medicaid costs must take into account a factor conspicuous by its absence –– the unreported provision of Medicaid services for illegal aliens, beginning with the birthing of infants of illegal alien mothers.
The Houston Chronicle reported in 2005 that 70 percent of the births in Houston and Dallas public hospitals were to undocumented immigrants. A Jan. 22, 2008, USA Today article did dare to address the rising costs of healthcare for illegal aliens, stating that “illegal immigrants rely on a patchwork of federally funded community health centers, which charge little for basic services and don’t seek proof of citizenship.”
Up until the 2010 election, attempts by Congressional Republicans to reign in Medicaid benefits for illegal aliens were routinely repulsed by the Democrat majority. Democrats rode a tide of liberalism that espoused, “If it feels good, it is okay.”
The result was irresponsible fiscal policy. Such fiscal proponents still abide in academia, the radical left, and the liberal news media; and their voices have become more strident since the 2010 electoral victories of new fiscal conservatives.
For decades Congress, state governors, and state legislatures have chosen to “kick the can down the road” to avoid responsibility for the mounting Medicaid debt. The current economic recession finally woke politicians to the fact that federal expenditures have outdistanced tax revenues. In November 2010, citizen-voters, many from Middle America, cast their ballots for fiscal responsibility.
A March 6, 2011, St. Petersburg Times article reported that Florida’s Medicaid is currently that state’s most expensive program at $22 billion. Projections are that the number of Medicaid recipients in Florida will rise from 2.9 million in 2011 to 3.2 million in 2012. The article chose not to address the number of new recipients who will be undocumented immigrants.
Reports by the Social Security Administration (SSA), dating back to 1970, show that states were experiencing organizational and administrative problems in dealing with national health expenditures, beginning with the definition of “medical indigence.”
States were permitting noncitizens, among them student visa holders and illegal aliens, to benefit from lax eligibility requirements. Medicaid eligibility has been widened often far beyond the law. For example, the District of Columbia provides that persons with incomes over the prescribed limit for Medicaid eligibility may qualify by adjusting their income with a “spend down” deductible.
Political correctness permeates the SSA and state governments with “subterranean” congressional approval. The result is that today untold numbers of illegal aliens posing as legal residents and U.S. citizens use forged and fraudulent documents to receive Medicaid benefits.
A GAO report of July 25, 1995, the last of its kind, estimated national costs for illegal aliens. The report stated that illegal aliens in the United States were generating more in costs than revenues of federal, state, and local governments combined; that these estimated costs varied greatly from $2 billion to $19 billion; and that a great deal of uncertainty surrounded the fiscal impact of illegal aliens –– then as now.
Behind the Medicaid mayhem is a congressional abdication of power. It is high time for members of Congress to regain control and reign in the bankrupting effect of waste, fraud, and abuse in Medicaid.
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