Former President Ronald Reagan once noted, “No government ever voluntarily reduces itself in size.” That’s true, which is why what’s currently happening with Medicaid is so remarkable.

During the pandemic, Medicaid enrollment grew dramatically because the federal government tied increased emergency funding to a provision that prevented states from removing ineligible individuals from the rolls. Earlier this year, Medicaid enrollment ballooned from 65 million people to more than 94 million. That’s more than a quarter of the country’s population.
So much for Medicaid being coverage of last resort for the neediest.

Reagan foresaw that outcome. The rest of his above quote states, “Government programs, once launched, never disappear. Actually, a government bureau is the nearest thing to eternal life we’ll ever see on this Earth.”

To prove his point, the White House kept renewing the emergency order even as the pandemic faded. This was a backdoor effort to permanently expand Medicaid.

But Republicans in December 2022 rescinded the continuous coverage mandate, forcing states to disenroll those who were improperly using Medicaid. Progressives — eager to see more Americans become government dependent — warned that enforcing eligibility requirements would lead to a massive spike in the uninsured.

That hasn’t happened.

As The Wall Street Journal noted in August, the Centers for Medicare and Medicaid Services projected a less than 1 percentage point increase in the number of uninsured Americans once the pandemic emergency provisions expired.

“Although Medicaid enrollment is expected to decrease significantly,” CMS concluded, “many individuals who were not disenrolled from Medicaid during the public health emergency already had comprehensive coverage from another source (such as through an employer) and thus remain insured even when disenrolled from Medicaid.”

The process is working. Already more than 11 million people have been disenrolled. Again, enrollment standards haven’t changed. States are now simply confirming eligibility and removing those who no longer qualify. In addition, there are safeguards in place — an appeals process, retroactive coverage — for those inaccurately removed from Medicaid because of bureaucratic snafus.

If Democrats want a debate about expanding this entitlement program, fine. But etching “temporary” pandemic emergency provisions in stone isn’t the way to go about it.

Cleaning the rolls by enforcing eligibility provisions will, reason.com noted, save taxpayers an estimated $80 billion annually.

Even for the government, that’s real money.

Las Vegas Review-Journal/Tribune News Service

Editorial cartoon by Chip Bok (Creators Syndicate)