Paragon Growing Team + Misguided Biden Medicaid Proposal

Today’s newsletter provides background on two new members of Paragon’s expanding team and an op-ed by Gary Alexander about a problematic Biden Administration Medicaid proposed rule. 
 
Welcoming Drew Gonshorowski and Joe Albanese to Paragon
 
Last week, Paragon added two more key employees: Drew Gonshorowski as a Senior Research Fellow and Joe Albanese as a Policy Analyst. 
 
Drew brings over a decade of experience conducting quantitative research and building models to examine health policy proposals and entitlement programs. Prior to joining Paragon, Drew worked in the Center for Data Analysis at The Heritage Foundation. At Heritage, he built and maintained models and databases, which were used to review legislation, supply data and analysis for news organizations, and inform policy research. His research included health policy with a special focus on microsimulation, Medicaid spending, and premium analysis. Drew has testified on Medicaid policies in many states. His work has appeared in several publications including The Wall Street JournalHealth Affairs, and The Hill.
 
Joe is an expert on Medicare, having worked as a Program Examiner on the Medicare team at the White House’s Office of Management and Budget (OMB) since 2019. While at OMB, he provided oversight of Medicare’s funding and operations, reviewed regulations and other major administrative actions, and contributed to publications such as the annual President’s Budget. Joe’s analysis and recommendations helped to shape policy decisions by White House and Department of Health and Human Services officials. 
 
Biden’s misguided Medicaid expansion proposed rule 

Gary Alexander, who leads Paragon’s Medicaid and Health Safety Net initiative, had an op-ed in the Washington Examiner on September 24th. The piece is about a proposed rule from the Centers for Medicare and Medicaid Services (CMS) that would significantly expand Medicaid enrollment, limit states’ eligibility reviews, and make it easier for ineligible people to continue to be enrolled. According to CMS’s estimates, the proposal would increase Medicaid enrollment by about three million people and cost taxpayers nearly $20 billion per year. From the op-ed:

Rather than give states more flexibility to better manage the program, address the surge of improper enrollment, and preserve the program for only those who are eligible, the Biden administration’s proposed rule would do the opposite. It would force states to enroll applicants without basic verification, leading to increased enrollment and more misspending.

Historically, many states checked eligibility at least every six months. But Obamacare limited states’ ability to conduct eligibility reviews for children and nondisabled adults to just once every 12 months.

Frequent eligibility reviews are important to ensure that the program is reserved for those who need it. Medicaid eligibility is affected by income fluctuations and changes in state of residence, household size, and other such life changes that do not happen on a yearly calendar. This misguided rule would prohibit more frequent eligibility reviews for the remainder of the Medicaid population, meaning many people would remain on the program even if they become ineligible for it.

Gary highlights many other problems with the proposed rule. He also makes the case for greater not less program integrity, citing that “Medicaid’s improper payment rate before the pandemic was 22%, costing taxpayers nearly $100 billion annually and nearly triple the pre-Obamacare improper payment rate. It is now likely much higher.” Ineligible enrollees in Medicaid could be close to 20 million people now, and the Congressional Budget Office has reported that many, if not most, of them also have employer coverage. 

Gary concludes, “Instead of making it easier for ineligible people to get on public welfare, the Biden administration should prioritize resources for the vulnerable and disabled by reducing the surge of Medicaid waste, fraud, and abuse. As a start, scrap this proposed rule’s express lane eligibility pathway.”

In the next few months, Paragon will be releasing several studies related to the Medicaid program with key recommendations for policymakers to improve the program for both recipients and taxpayers.

All the best,
 
Brian Blase
President
Paragon Health Institute

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Paragon Health Institute (PHI) is a non-partisan, not-for-profit policy research institute. Any views, beliefs, or opinions expressed by PHI’s Public Advisors are those of its Advisors and do not necessarily reflect the official policies or positions of PHI or its employees. Any views, beliefs, or opinions expressed by PHI or its employees belong solely to PHI and do not necessarily reflect those of PHI’s Public Advisors.