Department of Government Efficiency

President Trump has appointed Elon Musk and Vivek Ramaswamy to lead the new Department of Government Efficiency (DOGE). This is a promising sign that President Trump aims to target unnecessary and counterproductive government bureaucracy, reduce excessive regulations, and cut wasteful expenditures. DOGE should have a target rich environment in health policy given that so much of our health sector is characterized by inefficient bureaucracy, excessive regulations, and wasteful spending.

A Wall Street Journal editorial expresses optimism about DOGE and claims the project could be President Trump’s best idea. According to The Journal, “DOGE’s first order will be to pause enforcement of overreaching rules while starting the process to roll them back.” By contrast, in health care, the Biden administration has pursued a regulatory agenda of restricting consumer choices, favoring big businesses over small ones and funneling taxpayer money to special interests.

Paragon has published research that favors a deregulatory health care approach, including expanding association health plans so small employers have the same regulatory advantages that large employers receive in offering coverage, protecting Americans’ right to obtain coverage that best fits their needs, and rescinding costly Biden administration Medicaid rules that increase mandates on the private sector and lead to substantial new costs for taxpayers.

DOGE will also focus on slashing waste, fraud, and abuse from the federal budget. The Journal editorial cites Paragon, writing “there are other ripe targets, such as fraud in Affordable Care Act subsidies. The Paragon Health Institute estimates such fraud at $15 billion to $20 billion this year.” The Journal was referring to Paragon’s work exposing and quantifying The Great Obamacare Enrollment Fraud—the result of Democrats in Congress passing massive subsidy increases to insurers and the proliferation of fully subsidized plans that unscrupulous brokers and lead generators shamelessly promote with promises of cash. Congress can end this fraud by letting the enhanced insurer subsidies expire after 2025 and taking commonsense actions to verify applicants’ information prior to enrollment.

Paragon has done extensive work related to the rising costs of federal health programs and how they are unsustainable on their current trajectory. Last year, former top Trump budget official and president of the Economic Policy Innovation Center Paul Winfree authored an important paper for Paragon on how rising interest payments on the burgeoning national debt and rising federal health expenditures are responsible for the poor U.S. fiscal outlook.

Taking on the challenge of laying out needed health reforms, Paragon released Turning the Tide on Red Ink: Commonsense Policies to Make Federal Health Programs More Sustainable. We provided a menu of more than a dozen cost-cutting policy proposals, including ones that would reduce overpayments to hospitals and reduce state Medicaid financing gimmicks. We have subsequently released major proposals to improve Medicare Advantage, to modify the tax treatment of health care and health insurance, and to reform Medicaid financing by ending Obamacare’s discrimination against the most vulnerable.

DOGE’s efforts to reduce bureaucracy, fraud, waste, and abuse from government programs are long overdue. Paragon’s recommendations offer practical and significant ways to achieve this goal.

Meet Nebraska’s New Medicaid Director

It’s bittersweet for me to announce that Drew Gonshorowski will leave Paragon next month to begin a new chapter in his career as Director of Medicaid and Long-Term Care for the Nebraska Department of Health and Human Services. As one of the earliest members of the Paragon team, Drew has been instrumental in shaping our mission and building our reputation with high quality research and policy analysis.

Drew led much of Paragon’s data and analytic work over the past two plus years. He was my coauthor on some of Paragon’s most important papers, including The Great Obamacare Enrollment Fraud and Medicaid Financing Reform. Drew also played a key role in creating the Paragon Pic, making health policy easier to see and understand.

While his presence at Paragon will be greatly missed, we are confident he will excel in his new role improving health outcomes for Nebraskans with a focus on empowering patients and reforming government. Congratulations, Drew!

All the best,

Brian Blase
President
Paragon Health Institute