Earlier this year, The Federalist highlighted a Wall Street Journal investigation that found taxpayers had spent billions paying for individuals who had enrolled in Medicaid in multiple states simultaneously. The kicker is not surprising but still shocking: As bad as the Journal exposé seemed, the reality is worse.
A new investigation increased both the number of enrollees with duplicate forms of taxpayer-funded coverage and the amount taxpayers are paying for such unnecessary double-dipping. It provides an example — one of many — to rebut leftist claims that the recently passed budget reconciliation bill will somehow destroy the safety net.
Explosion of Wasteful Spending
The Journal analysis of Medicaid data from 2019 to 2021 found taxpayers spent $4.3 billion over three years, providing duplicate coverage to an average of 660,000 people per year. The Trump administration recently examined what happened after four years of Biden administration policies, designed to promote enrollment in taxpayer-funded coverage at all costs.
The analysis by the Centers for Medicare and Medicaid Services (CMS) of 2024 enrollment data concluded that, last year, “an average of 1.2 million Americans each month were enrolled” in Medicaid in multiple states — nearly double the level of duplicate enrollment cited by the Journal in the opening years of the Biden presidency. Moreover, CMS also noted that another “1.6 million Americans each month were enrolled in both Medicaid” and taxpayer-subsidized coverage on the insurance Exchange plans.
According to CMS, the total cost of all this unnecessary spending on a total of 2.8 million duplicate enrollments is $14 billion per year — more than three times the $4.3 billion figure the Journal reported earlier this year. CMS didn’t specify if that $14 billion figure represented total Medicaid costs (i.e., including the share of Medicaid costs that states pay themselves), or only the potential costs to the federal government.
Regardless, it represents a large amount. For purposes of comparison, the Congressional Budget Office (CBO) estimated that, during the last fiscal year, the federal government would spend $607 billion on Medicaid. Simply eliminating the duplicate payments would reduce federal Medicaid spending by roughly 2.3 percent — without doing anything to harm beneficiaries, who would still have taxpayer-funded coverage, just not in multiple places at once.
Phony Coverage Losses?
The CMS data highlights two important points regarding Medicaid and taxpayer-funded insurance programs. First, the discussion about the number of individuals who will “lose” coverage seems overstated.
CBO has yet to release detailed coverage estimates regarding the final version of the bill, enacted into law. But the case described above demonstrates the absurdity of this type of exercise. The left might scream about 2.8 million people “losing” coverage — even though they “lost” coverage only on paper and are still insured elsewhere (and at taxpayer expense) in the system.
Many of the other supposed “losses” from the legislation fall into similar buckets: individuals who choose not to comply with the new work requirements, undocumented migrants denied taxpayer-funded coverage for public policy reasons, and so forth.
A good percentage of Americans would have few qualms about lawmakers making these types of reasonable policy judgments. And yet the left hopes to overwhelm such rational behavior with screaming headlines talking about Trump taking away health care from 15 million Americans.
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