Today, Paragon released a new policy brief I authored, “Managed Care in Medicaid, Need for Oversight, Accountability, and Reform.” The brief reviews the significant increase in Medicaid enrollment and spending over the past several decades, with a particular focus on the growth from the Affordable Care Act’s expansion of the program and from federal COVID-19 policies. The brief also discusses a new report from the Inspector General at the Department of Health and Human Services that shows significant problems with government oversight of Medicaid managed care. The final section of the brief provides specific recommendations for information that congressional investigators should obtain in order to conduct oversight related to the value that enrollees and taxpayers are receiving from the now nearly $600 billion of annual federal Medicaid spending.
Key Takeaways from the Policy Brief
- Given the failures of insurers, states, and CMS, congressional oversight is desperately needed to ensure recipients and taxpayers are receiving value from Medicaid.
- The ACA and COVID-19 Medicaid policies have exacerbated improper enrollment and spending in the program with now more than 15 million ineligible recipients.
- Medicaid managed care spending now exceeds $420 billion annually, and a new report from the HHS Inspector General shows a lack of accountability with this spending as insurer profits on Medicaid expansion skyrocket.
Paragon is committed to evaluating how government programs are actually working for recipients and taxpayers. This work complements a report that Paragon issued last week, “Long-Term Care: The Problem,” which contains a critique of Medicaid’s contribution to our nation’s long-term care challenges.
All the best,
Brian Blase
President
Paragon Health Institute
