ONE BIG BEAUTIFUL BILL REFORMS MEDICAID TO BETTER SERVE BENEFICIARIES

This is a guest blog written by Dean Clancy, senior health policy fellow at Americans for Prosperity.

“The One Big Beautiful Bill guts Medicaid” is a convenient soundbite for those who oppose the bill.

But it isn’t true.

The bill — signed into law on July 4 — simply reforms Medicaid to better serve the vulnerable populations it was created to protect.

Over the years, Washington lost sight of Medicaid’s core mission. It’s been expanded far beyond its original purpose, adding millions of otherwise ineligible recipients and driving the program down an unsustainable path.

MEDICAID LOST ITS WAY, AND THAT’S COSTING US.

Medicaid was created in 1965 with a focused and limited mission — to provide health care coverage for the poorest Americans, including low-income families, people with disabilities, and pregnant women.

And for decades, Medicaid stuck to its core mission.

Enrollment rose during tough times and fell when the economy was booming. But it was always a safety net.

That changed over the past decade and a half.

The Affordable Care Act, along with state expansions, opened Medicaid to people who were never intended to be part of the program, like able-bodied, childless adults.

Enrollment surged by 30 million people, and spending nearly doubled, now exceeding $800 billion annually.

The result? Longer wait times, fewer available doctors, and substandard care for the people Medicaid was designed to serve.

And it’s not just Medicaid.

According to the Congressional Budget Office, the Biden administration’s push to flood federal health programs with new enrollees — regardless of eligibility — added $1.9 trillion in projected spending over the next decade.

This chart from our friends at the Paragon Health Institute shows Medicaid and Obamacare spending growth under Biden and the OBBB.

• The light blue line shows spending if these programs had stayed at their historical level.
• The dark blue line shows how the Biden spending spree shifted the spending up dramatically.
• The yellow line shows how the OBBB restores sanity — by returning growth to a responsible, sustainable pace.

Just the other day, federal officials revealed that 2.8 million Medicaid recipients are unlawfully enrolled in more than one state, or enrolled in both Medicaid and another federal health care program for which they’re not eligible. This wasteful, duplicative enrollment is costing taxpayers at least $14 billion a year.

WHAT THE ONE BIG BEAUTIFUL BILL ACTUALLY DOES

The One Big Beautiful Bill starts to put Medicaid back on solid footing.

Even with the Medicaid reform in the bill, Medicaid’s budget will continue to grow, just at a more responsible rate. There is no “cut.”

The bill reins in waste, restores eligibility integrity, and ends the open-door policies that allowed enrollment to skyrocket.

Here’s what it actually does:

• Brings back commonsense eligibility checks by ending the pandemic-era automatic renewal policy that allowed millions of unqualified people to stay on the rolls.
• Helps states verify income and other basic requirements before handing out benefits.
• Ends state incentives to enroll new people regardless of eligibility.
• Gives states better tools to crack down on waste and abuse.
• Returns Medicaid’s focus to the truly vulnerable by adding a work requirement for able-bodied, childless adults.

WHY THIS FIGHT ISN’T OVER

It’s good that commonsense reforms have placed Medicaid on a better, more sustainable track.

But no win is permanent, and the special interests know it.

A recent Politicostory says it best. Many of the Medicaid changes will take a couple of years to implement fully. Hospitals “are already gearing up to use the next two and a half years to persuade lawmakers to rescind” them.

WE NEED TO GO ON OFFENSE.

Instead of just playing defense against false attacks, we need to go on offense and give the special interests that dominate our rigged health care system something real to worry about: free-market reforms that empower patients, not the system. That’s why it is so important we keep pushing our Personal Option plan in Congress.

This plan would build on the good, patient-empowering reforms in the Big Beautiful Bill to:

• Make tax-free health savings accounts available to all Americans
• Expand access to trusted doctors through direct primary care for even more Americans
• Reduce hospital costs by promoting true competition and price transparency
• Make health insurance truly portable and affordable
• Remove barriers to convenient, affordable telehealth

There is still a LOT more to do, and we need to keep the bloated health care system on the defensive!

You can help by signing our Personal Option petition, showing Congress that Americans support reforms like HSAs, telehealth, and DPC.

Please take 60 seconds to sign our petition — every signature we bring to lawmakers strengthens the case for these critical changes.