Econception Medicaid, Manufacturing, and Fiscal Responsibility
Apr 28, 2025
In a thought-provoking discussion, Brian Blase, former Special Assistant to the President for Economic Policy, and Paul Winfree, founder of the Economic Policy Innovation Center, tackle the urgent need for Medicaid reform. They reveal how the program often supports wealthier entities despite its intentions. The duo contrasts Germany's manufacturing successes with U.S. growth patterns, while also critiquing fiscal irresponsibility, drawing lessons from Greece and Argentina. Insights from the Oregon Health Insurance Experiment highlight unexpected outcomes of Medicaid expansion on health and financial security.
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Medicaid Expansion Impact
- Medicaid expanded under the Affordable Care Act to include able-bodied working-age adults beyond the poor.
- This resulted in a surge in enrollment and spending, now covering about one in four Americans.
Medicaid Money Laundering Explained
- States use accounting tricks like taxing providers and then paying them back to claim higher federal Medicaid reimbursements.
- This 'money laundering' inflates federal spending without actual new state expenditures.
Misaligned Medicaid Incentives
- Medicaid expansion incentivizes states to prioritize able-bodied adults over the vulnerable groups it was meant for.
- This shift undermines care access for disabled, children, and pregnant women.