Everyone supports cutting government spending, until someone actually begins to cut government spending. Then, all Hell breaks loose.
Why? Because with a $6 trillion federal budget, far too many politicians and activists (and donors and universities and corporations) have their hands in the till. As Senator John Kennedy, R-La., has memorably said, when you start to cut the fat, the pigs will squeal.
On cue, Democrats are squealing. It turns out that they benefit from some of the wasteful spending being exposed by the Trump White House, as monies designated for addressing climate change, for instance, inappropriately flow to leftist think tanks and non-profits.
Thanks to the work of Elon Musk’s Department of Government Efficiency (DOGE), Americans are getting a quick education on the ‘soft’ corruption corroding our government. It is not pretty. In his address to Congress, President Trump listed several idiotic expenditures of government monies; studies on transgender mice (which CNN and others wrongly claimed didn’t exist) received a lot of attention, and rightly so. Those disclosures may be why a new Rasmussen poll shows two-thirds of the country agree that it’s time to ‘drain the swamp.’
Democrats disagree; in an effort to undermine Elon Musk and President Donald Trump, they are fearmongering, warning voters that DOGE or Republicans in Congress are going to slash Medicaid benefits. President Trump is on record saying his government will not cut that program, but will investigate fraudulent payments.
House Democratic Minority Leader Hakeem Jeffries, recently said the GOP House spending bill would ‘set in motion the largest Medicaid cut in American history.’ New York Representative Mike Lawler disputed Jeffries’ claim, saying ‘show me where in the budget resolution it talks about specific cuts. It doesn’t.’ Lawler is correct, but Democrats insist that the plan’s $880 billion expected cut in spending from programs under the House Energy and Commerce Committee’s jurisdiction, like healthcare outlays, prove the program will be gutted.
The truth is that simply rooting out fraudulent payments from Medicaid (and Medicare) would go a long way towards providing that sort of savings. Last year, the GAO reported ‘improper payments’ from federal Medicaid outlays amounted to $51.3 billion in 2023 (and Medicare’s improper payments totaled another $51 billion). The Medicaid figurewas significantly higher in prior years, and only fell because of ‘flexibilities granted to states during the COVID-19 public health emergency.’ In 2021, fraudulent payments totaled $103.4 billion and in 2022 totaled $83.1 billion. The GAO warns the improper payments rate is likely headed higher.
Medicaid spending has more than doubled over the past decade, despite real median incomes expanding by 14% and the poverty rate plunging from 14% to 11.5%. There were 48.3 million Americans living in poverty in 2013 in the U.S.; by 2022 that number had dropped to 41.9 million. Given that Medicaid is mainly a program targeting low-income Americans, the numbers do not make sense.
One reason that Medicaid has grown so rapidly is that President Obama and then President Joe Biden instituted changes that encouraged enrollment expansion. When Barack Obama took office in 2009, there were 51 million Americans receiving Medicaid; by the end of his presidency, there were 74 million, a rise of 45%. Obama encouraged greater participation by loosening work requirements for receiving Medicaid. President Trump allowed states to reimpose that demand during his first White House term; as a consequence, in part, the number of enrollees in Medicaid barely budged, rising from 74 to 76 million. Had it not been for the COVID outbreak, the number would likely have stagnated under Trump.
President Biden, in the year before he expected to run for a second term, pushed through rules changes that significantly increased Medicaid’s enrollment and costs, according to the Centers for Medicare and Medicaid services. The CMS estimated the federal cost of Biden’s rules at between $68.5 billion and $134.8 billion over five years. One rule weakens the eligibility requirements of enrollees in part by mandating that state Medicaid programs discount pensions, annuities and retirement funds in determining income levels.
In addition, some states, like New York, have allowed illegal immigrants to receive Medicaid; that has boosted the numbers as well.
Why do Democrats work to expand Medicaid? Because, like any other benefit, recipients often reward state officials for their supposed generosity, indifferent to the costs. Democrat-run New York, for example, spent $94.6 billion on Medicaid in fiscal 2023, or more than $4,800 for each resident; that was 82% above the national average. The state alone paid out $1,800 per capita on Medicaid, more than double the U.S. average of $835.
Readying their opposition to trimming the program’s out-of-control outlays, Democrats invited Medicaid beneficiaries to attend Trump’s address to Congress, hoping to highlight their dependence on the program. During the speech, Democrats chanted and waved lollipop signs that said ‘SAVE MEDICAID;’ as it happened, their embarrassing shenanigans – and especially their sullen refusal to applaud a young cancer victim or a hostage brought home from Russia – drowned out their message.
They will not stop, however. Progressive mouthpiece Rep. Alexandria Ocasio-Cortez, D-N.Y., said on Instagram after the speech: ‘Trump not mentioning Medicaid at the State of the Union is the game. He doesn’t talk about it, what he fears, and he knows it’s dynamite.’
It actually may turn out to be dynamite, an explosive issue favoring Republicans. A new survey by pollster Scott Rasmussen reveals that ‘71% of voters support reducing growth of Medicaid spending by removing illegal immigrants and requiring able-bodied recipients to work. 88% of Republicans and 51% of Democrats back the proposal.’
If even a majority of Democrats agrees that Medicaid spending has to be curtailed, the mandate for reform is stark. My view: cut spending that nearly everyone agrees is ‘unsustainable’ and let them squeal.