by Mitch Kokai
Senior Political Analyst, John Locke Foundation
Medicaid was intended to be a safety net for the truly needy. But over time, both federal and state policymakers have lost sight of Medicaid’s core purpose and turned the program into a catch-all, open-ended welfare program for non-disabled adults.
Obamacare made this problem even worse, giving states the option to expand Medicaid to even more able-bodied adults. Nearly 13 million have been added since that expansion went live in 2014. Today, able-bodied adults in the program now outnumber individuals with disabilities — the people Medicaid was largely designed to serve — by a staggering 17.5 million.
Medicaid has clearly lost its focus, as I detail in a new report for the Foundation for Government Accountability. The most stunning finding: At least 21,904 individuals have died on Medicaid waiting lists in states since they expanded their programs.
The waiting lists are comprised of individuals with intellectual disabilities, traumatic brain injuries, spinal cord injuries, and even the elderly. These individuals are waiting for additional Medicaid services — home- and community-based care, specifically — beyond what states are required to cover through Medicaid. Because these additional services are optional, states can limit enrollment in these waiver programs. Once that limit is reached, additional applicants are forced onto the waiting list.
To put a finer point on it: Expansion states have chosen to spend tens of billions of dollars on non-disabled adults instead of helping those on the waiting list.