In his first week back in the White House, President Donald Trump issued several executive orders related to health policy. But lasting action on healthcare reform, from reining in wasteful or fraudulent Medicaid spending to rolling back billions in premium subsidies, can only come from Congress, which holds the power of the purse.
It’s imperative that Congress get a handle on spending. The national debt has already surpassed $36 trillion. Just a few spending reforms, predominantly to entitlements, could save taxpayers $5.7 trillion over 10 years, according to the House Budget Committee.
Medicaid cuts alone would yield an estimated $2.3 trillion in savings. Some of the proposed reforms include capping spending per Medicaid enrollee ($918 billion), reducing the minimum federal “matching rate” so states receive less federal assistance for every dollar they spend on Medicaid ($387 billion), and implementing work requirements for qualified Medicaid enrollees ($120 billion).
State Medicaid programs currently receive more federal funding for covering able-bodied adults than they do for covering the entitlement’s legacy population: the poor, the disabled, and pregnant women. Removing this discrepancy could save up to $690 billion.
Republicans can also let Democrats’ costly enhanced premium subsidies for Obamacare expire at the end of the year, as scheduled.
The subsidies allow people earning under 150% of the federal poverty line, $46,800 for a family of four, to get exchange coverage without paying a cent in premiums. Even people earning more than 400% of the federal poverty line, $124,800 for a family of four, need not pay more than 8.5% of income for coverage.
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Democrats are agitating to make those subsidies permanent. But doing so would cost taxpayers $335 billion over the next 10 years, according to the Congressional Budget Office. That figure doesn’t include $48.3 billion in additional interest payments.
It would be irresponsible of Republicans not to end this drain on taxpayer coffers. Republicans finally have a chance to dream big on healthcare and give Trump’s Sharpie some substantive legislation to sign. Let’s hope they don’t waste the opportunity.
Sally C. Pipes is president, CEO, and Thomas W. Smith fellow in healthcare policy at the Pacific Research Institute. Her latest book is False Premise, False Promise: The Disastrous Reality of Medicare for All (Encounter 2020). Follow her on X @sallypipes.
This article was originally published at www.washingtonexaminer.com
