Three Reforms to Strengthen Medicaid and Prioritize the Most Vulnerable

Medicaid is a critically important safety net program that serves the most vulnerable in every community and it is imperative that these vital tax dollars are spent taking care of those in the greatest need.

Today, the Energy and Commerce Committee’s Health Subcommittee will examine three commonsense reforms, authored by us individually, to ensure Medicaid is working for those it serves. The bills cover a range of issues within the program, but work toward the common goal of strengthening the program so beneficiaries can make the most of these important benefits.

Medicaid is meant to help the most vulnerable amongst us — not high-dollar lottery winners. However, under current law, lottery winnings are counted as income only in the month they are received. That means even multi-million dollar jackpot winners are allowed to stay on their state’s Medicaid program over the longer-term, if they do not have other sources of income. This provides an undue burden for taxpayers, forcing folks to pay for the health care benefits of newly-minted millionaires.

The Prioritizing the Most Vulnerable Over Lottery Winners Act of 2017, authored by Rep. Upton, is a reasonable solution to this problem. This bill would alter how Medicaid eligibility is determined for those lucky enough to hit it big playing the lottery while continuing to prioritize the low-income population the program is meant to serve.

The Close Annuity Loopholes in Medicaid Act, authored by Rep. Mullin, is another bill that helps strengthen Medicaid by ensuring individuals with significant means are not burdening taxpayers instead of paying for their own care. The CALM Act saves money in Medicaid by getting rid of a loophole certain married couples use to intentionally shelter their assets by creating annuities. The Government Accountability Office reported that some spouses on Medicaid are masking resources of over $1 million. By pursuing policies like the CALM Act, we can ensure that Medicaid coverage is for the truly needy – rather than providing care for those masking their high income.

And finally, while Medicaid generally does provide coverage for individuals who are not lawfully present in the U.S., a small provision of law forces states to provide temporary coverage for 90 days for individuals who apply for coverage – even if they cannot prove they are here legally. The Verify Eligibility Coverage Act, authored by Rep. Flores, addresses this abuse of hardworking taxpayer dollars by simply preventing states from being allowed to claim federal funds for the purpose of providing for Medicaid coverage unless applicants have provided satisfactory evidence of citizenship or eligible immigration status. 

These three bills are sensible policies that most Americans support. Medicaid is an important program, relied upon by those in need of our assistance. In order to help prioritize the most vulnerable, a portion of the savings from each of these bills would be given to States to help remove patients from Medicaid waiting lists.

As we work to rebuild our health care system, today’s check-up on the Medicaid program is an important step in the right direction. By pursuing these straightforward improvements and other reforms, we can maximize our dollars while helping improve the quality of care our most vulnerable citizens receive.


Reps. Fred Upton (R-Mich.), Markwayne Mullin (R-Okla.) and Bill Flores (R-Texas) are members of the House Energy and Commerce Committee.

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