North Carolina’s already overextended Medicaid program is expanding rapidly, courtesy of the legislature’s decision to expand it last year. Nearly 450,000 people have signed up in just five months since the program opened up to the expansion population.
Total enrollment in the state’s Medicaid program has reached just under 3 million, meaning that more than 1 in 4 North Carolinians are reliant on this government program for their healthcare coverage.
Accompanying expansion hand in glove will be a spike in fraudulent “improper payments.” Such wasteful spending often occurs because people who were insufficiently vetted for the program end up enrolled when they shouldn’t be, and begin receiving benefits.
The Paragon Health Institute documents just how sharply improper payments in Medicaid increased after Obamacare enabled states to expand their Medicaid programs.
“The Affordable Care Act’s Medicaid expansion has resulted in a massive increase in federal Medicaid improper payments, which soared from an estimated $14.4 billion in 2013 to $98.7 billion in 2021”
Due to a suspension of meaningful audits during COVID, the 2021 data remains the most meaningul data, but still likely undercounts the amount of fraud in the program.
More than 1 of every 5 Medicaid dollars spent in NC will be made improperly.
Improper payments make up more than 21 percent of all Medicaid spending nationally, according to Paragon’s research. If that holds true in North Carolina, we should expect that more than 1 of every 5 Medicaid dollars being spent will be made improperly.
