Analysis Reveals Medicaid Spending Waste from Eligibility Verification Lapses
. The analysis highlights rapid Medicaid enrollment growth from 60 million in 2013 to 100 million in 2023, driven by regulatory changes that loosened eligibility verification. This surge led to Medicaid spending hitting $919 billion in 2023, double the cost from a decade earlier, with federal taxpayers covering nearly 80% of the increase.
According to the Foundation for Government Accountability, over 20% of Medicaid spending is improper, mainly due to eligibility errors, fraud, and duplicative claims, potentially reaching $2 trillion in improper payments over the next decade. Key regulatory shifts started in 2012 when the Centers for Medicare and Medicaid Services altered verification requirements, reducing the frequency of eligibility reverification and loosening income and household information validation.
Subsequent administrative changes under the Biden administration created loopholes allowing extended eligibility periods and increased Medicaid enrollment among illegal immigrants, significantly contributing to improper payments. The report cites examples like Louisiana and New Jersey audits revealing enrollment of ineligible individuals and beneficiaries with unreported high incomes.
A related recent polling survey showed public support in key congressional districts for reforms aimed at eliminating waste and restoring eligibility enforcement. The analysis underscores ongoing legislative efforts to reform Medicaid eligibility requirements to reduce improper spending while maintaining coverage for those genuinely in need.