Issue Position: Medicare & Medicaid

Issue Position

For better or worse, Medicare and Medicaid serve as essential cornerstones in our nation's health care system. Over 55 million Americans currently rely on Medicare, while an estimated 65 million individuals depend on Medicaid. Unfortunately, the programs were not designed to be sustainable. Systemic changes will be needed sooner rather than later to prevent the entire system from becoming insolvent. I look for structural changes that will address the unchecked growth of these programs, reduce waste, fraud and abuse and increase state flexibility.

Unchecked Growth

Both Medicaid and Medicare are on autopilot in terms of funding. Their budgets are not subject to Congressional approval -- the money just gets spent. There is no limit on the growth of these programs. As you can see, they take up a greater share of the budget every year.

Medicare spending increased to 20 percent of National Health Expenditure (NHE) in 2014, while Medicaid rose to 16 percent of NHE. In Fiscal Year 2016, Medicare will cost over $675 billion dollars alone. The cost of these programs are felt most by the American taxpayer; the largest shares of total health spending are sponsored by individual households and the federal government. Medicare and Medicaid costs pose a significant threat to our national budget, we simply cannot afford to continue allowing unrestrained growth of these programs. We must find a way to reign these programs in, reduce duplicative and unnecessary spending, streamline health care, and ultimately ensure high quality and effective care for our citizens.

Waste, Fraud and Abuse

Despite the critical importance of Medicare and Medicaid, they, like so many government programs, are fraught with waste, fraud, and abuse. Recent estimates suggest $60 to $90 million in Medicare fraud, and similar numbers for Medicaid. Wasteful spending abounds across both programs, with duplicative spending and failure at all levels to streamline our health care system. While these programs remain critical, we must address the skyrocketing costs in order to mitigate long term issues. Strong government oversight and increased flexibility for states, especially with regard to Medicaid, will help control the unnecessary over-expansion of these programs.

Increasing State Flexibility

Medicaid is administered at the state level to provide coverage for low-income children, pregnant women, parents of dependent children, the elderly, and individuals with disabilities. Since the passage of the Patient Protection and Affordable Care Act (also known as Obamacare), Medicaid has also provided coverage for those individuals with income up to 133 percent of the federal poverty level.

States bear a percentage of the cost of Medicaid benefits and have a strong incentive to increase efficiency and reduce cost.

Utah has made great strides to reign in the costs and waste associated with Medicaid, only to have the federal government deny the waivers needed to implement state reforms. I favor increasing flexibility for states who administer Medicaid.

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