By Jim Soviero
For much of the past six months, Democrats have loudly warned about supposed doomsday “cuts” to Medicaid. The irony is that some of these same powerful politicians were previously, very publicly calling for cutting the waste, fraud and abuse, threatening this program’s long-term sustainability.
U.S. Representative Nancy Pelosi (D-California) stated, “We should reduce the cost….on Medicaid.” Then-President Barack Obama (D-Illinois) candidly admitted that “getting rid of the deficit” would mean “cutting back billions of dollars on programs a lot of people care about.” His vice president Joe Biden (D-Delaware) announced the Department of Health and Human Services is “launching a program to cut waste in Medicaid.” Our own Senator, Chuck Schumer (D-New York), proclaimed that “waste, fraud, abuse and duplication” must be wrung out of both Medicare and Medicaid.
So, if the language Dems have used before is eerily similar to what Republicans have been saying now, why all the hysteria? It’s political. The dirty D.C. secret is year-to-year dollar amounts allocated to Medicaid don’t actually shrink. Democrat grandstanding about “cutting” the program’s costs was basically performative, as are many of their attacks against GOP rivals regarding the same subject.
That’s because our federal government employs a system of accounting called “baseline budgeting.” We simply use the current year’s budget as a starting point for next year’s budget, which means even just slowing the rate of growth can, for political gain, be grounds to label your opponent as “heartless.”
When politicians gain power from distributing other people’s money, there’s little incentive to stop that gravy train. It tempts them to needlessly increase their spending, meaning inefficiencies and bloat are automatically rolled into new budgets.
We have a timely example: In 2019, federal outlays for Medicaid were $409 billion. This year, the price tag is projected to hit $655 billion. That’s a 50% leap, even well after the COVID pandemic passed.
Most taxpaying families and businesses trying to balance their checkbooks don’t have that luxury. They use more of a zero-based approach. That means starting from $0 in as many categories as possible, and then attempting to justify both old and new expenditures based on proven needs and costs.
Elected officials should trade their “foggy” accounting for commonsense models used by “regular” folks, who’ve successfully managed balance sheets and household budgets for decades. The latter might also better serve the long-term viability of Medicaid, which is supposed to be the ultimate goal.
One way or another, hardworking Americans deserve an “honest count” from our federal government regarding supposed “cuts” to Medicaid, and they’re not getting it.
Jim Soviero is a retired teacher and a successful small business owner. He resides in East Setauket.