Medicaid Program Tilting Out of Control From ACA InfluenceAt least 21,000 Americans have died waiting to enroll in Medicaid, thanks in part to the expansion of the ACA government healthcare program, based on research reported by the Foundation for Government Accountability (FGA). See “The Medicaid Waiting List Crisis” reportThe report focuses primarily on the waiting lists generated by the Home and Community-Based Services (HCBS) waiver program. That program, created in 1981, allows states to extend Medicaid services to individuals in their home and/or community, meaning they do not need to be cared for in a nursing home or similar institutions. HCBS recipients tend to be those with severe intellectual disabilities, traumatic brain injuries, spinal cord injuries, and mental illnesses.State-by-state research data by the FGA notes that:– Able-bodied adult enrollment has quadrupled over the last two decades, from seven million to over 28 million.- Able-bodied adults now exceed disabled recipients by 17.5 million.FGA estimates that Medicaid waiting lists currently total 650,000 individuals. By contrast, more than 28 million “able-bodied” adults are now enrolled in the program and consume resources that would otherwise be allocated to individuals on the waiting list.HCBS programs are operated in all but three US states. Since the programs are optional, states can establish caps on enrollment, with waiting lists for those whose applications exceed the cap. Those waiting lists cover 38 states, with as many as 73,000 people waiting for Medicare service in Louisiana alone.Using State-by-State Data – FGA Findings:– At least 21,904 waiting list members who have died waiting for Medicaid service since the ACA expansion began- Many states did not track waiting list deaths, or gave only partial responses, implying that the true number may be much higher.- Unfortunately, individuals on the waiting list can spend years – sometimes up to a decade – waiting for access to much-needed Medicaid money.- The average wait time in New Mexico, for example is now 10.2 years, according to FGA data.Medicaid Has Morphed from Its Original PurposeThe FGA report highlights that able-bodied adult enrollment has quadrupled over the last two decades: from seven million to more than 28 million. Able-bodied adults now exceed disabled recipients by 17.5 million.The report also reflects that the ACA expansion has contributed substantially to this issue. As Medicaid has expanded – source – to cover able-bodied adults with a household income of at most 133% of the federal poverty level, resources that could otherwise be allocated to the most needy on a waiting list are now being used for otherwise able-bodied adults.Of the 650,000 currently on waiting lists, 250,000 are currently residents of states that opted to expand Medicaid under the ACA, including Ohio, where 62,118 are waiting for Medicaid.Many fear that Medicaid has lost its focus. The Medicaid program was formed to treat the blind, the disabled—- individuals who truly need Medicaid for survival in many cases. One FGA research report reflects that the program is currently out of whack and has conflicting priorities.Three FGA Proposed Solutions to Help Medicaid Prioritize Those “Most Needy”: – It called for an end to the Medicaid expansion, a move that some states are already considering or beginning to implement.- It recommended imposing work requirements for able-bodied enrollees, to help them off the dole and into the workforce.- It encouraged states to “attack welfare fraud,” helping to reserve billions of dollars to those most in need.Expansion states and non-expansion states must examine their Medicaid programs and ensure they’re doing everything possible to protect limited resources for people who are truly vulnerable and truly need help.Source: The Washington Free Beacon

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