Biden encouraged states to propose waivers to broaden Medicaid coverage during his presidency, resulting in the CMS approving some states’ requests to use Medicaid funds to pay for non-medical expenses for some individuals, such as rent, air conditioning and food
Democrats’ push to massively expand Medicaid over the past several years has turned the program into something nearly unrecognizable.
A series of reports have outlined the growing list of problems at the Centers for Medicare and Medicaid Services (CMS), including improper payments, healthcare funds being used for non-medical expenses and able-bodied adults receiving funds meant for Americans who may desperately need it. Former President Joe Biden’s CMS massively expanded Medicaid benefits during his sole term, driving Medicaid spending up from $734 billion at the beginning of his term to $871.7 billion in 2023.
“The big thing that’s sort of missing is [Medicaid’s] role of covering able-bodied adults in this,” Edmund Haislmaier, a health care policy expert at the Heritage Foundation, told the Daily Caller News Foundation. “Medicaid was originally set up to cover what we would call vulnerable enrollees, basically people who could not work and could not expect to have other sources of income or [medical] coverage. So you’re talking about poor children, low-income senior citizens, and disabled people. That is the core focus, and it’s also been expanded to include poor pregnant women over the years. What happened with the Affordable Care Act (ACA) is it was further expanded [Medicaid] to include able-bodied adults below a certain income level.”
A provision under the ACA, which was signed into law by former President Barack Obama in March 2010, called for Medicaid to be expanded to provide coverage for adults under age 65 with incomes up to 138% of the federal poverty level. Roughly 35 million able-bodied adults were enrolled in Medicaid programs while not working as of May 2023, according to estimates from the Foundation for Government Accountability, a conservative think tank.
Similarly, the Obama-Biden administration also oversaw sweeping expansions to Medicare coverage by abolishing a rule in 2014 preventing Medicare from funding sex-change surgeries. Obama’s administration also expanded coverage for sex-change procedures in 2016 through their interpretation of Section 1557, a non-discrimination provision of the ACA, which helped pave the way for Medicaid funds to be used to cover sex-change operations in certain states.
From January 2018 to September 2023, 16 states funneled over $165 million toward so-called “gender transition services.”
“The argument that we and others make is ‘look, why is the federal government giving states more money for covering people who have other options, like getting a job and getting coverage privately, and less money for people who need it the most, like disabled people,’” Haislmaier added. “That’s something that should be fixed in reforms.”
Biden also encouraged states to propose waivers to broaden Medicaid coverage during his presidency, resulting in the CMS approving some states’ requests to use Medicaid funds to pay for non-medical expenses for some individuals, such as rent, air conditioning and food. In April 2024, the federal government approved a request from Massachusetts to use Medicaid funds to pay for up to six months of temporary housing for eligible families and pregnant individuals who are MassHealth members residing in the emergency shelter system.
In the waning weeks of Biden’s presidency, his administration’s CMS also granted Vermont approval to use Medicaid funds to cover the cost of rent for some homeless individuals in the state.
For fiscal year 2025, Medicaid programs are projected to cost roughly $656 billion, according to the Congressional Budget Office.
Notably, the U.S. spends more on healthcare per individual than any other similar country, with health expenditures per person costing $12,555 in 2022, which was over $4,000 higher than any other high-income country. The rate of improper Medicaid payments in 2024 was 5.09% — or $31.10 billion — 79.11% of which was the result of insufficient documentation, according to the CMS.
House Republicans on Feb. 25 advanced a budget resolution calling for major reductions to overall federal government spending, but Congress has not yet made any specific proposals involving Medicaid. Many Democrats have repeatedly said that Medicaid funding is at risk of potential cuts by Republican lawmakers, despite President Donald Trump recently emphasizing that he does not want to see any drastic changes to the program.
While Republicans on the House Ways and Means Committee circulated a list of possible cuts to Medicaid funding in recent weeks, the potential cuts were primarily focused on removing illegal migrants from eligibility, which they claimed could save up to $35 billion over the course of a decade.
Trump told Fox News’ Sean Hannity during a Feb. 14 interview that Medicaid will not be “touched” aside from cases of fraud or illegal migrants found to be misusing the program. Still, Democratic lawmakers have continued making claims in recent weeks that Medicaid funding is in peril.
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Federal Dependency Is A Ticking-Time-Bomb For State-Budgets
Imagine finishing high school and realizing that no matter what path you take – college, a job, or starting a business – your money doesn’t go as far as it should.
Your car loan is more expensive, rent keeps rising, and groceries cost more monthly.
If you go to college, tuition is higher; if you don’t, more of your paycheck disappears in taxes.
This isn’t just bad luck – it’s the result of reckless government spending that fuels inflation, drives up interest rates, and makes it harder for everyone to get ahead.
In fiscal year 2023, federal funds to state and local governments totaled $1.1 trillion, nearly one-fifth of all federal spending and 4 percent of US GDP. This money doesn’t come free — it’s taken from taxpayers, borrowed from future generations, or printed by the Federal Reserve, creating inflation.
Even states that claim to be fiscally conservative are hooked on federal money. Texas took in $102 billion for its 2024-2025 budget, nearly one-third of its total budget. That means Texas, like all states that average 36 percent of their budget from federal funds, is highly tied to federal mandates for what it wants to do.
The biggest driver of this dependency is Medicaid, which received $616 billion in federal spending in 2023, over half of all federal funds to states. Many states expanded Medicaid with temporary federal funds, but when Washington inevitably pulls back, states will be forced to raise taxes, cut services, or both, burdening many families. The same pattern applies to federally backed education and transportation spending.
The more states rely on Washington, the less control they have over their policies.
This isn’t just about wasteful spending — it directly hits American households. More deficit spending contributes to higher interest rates, making mortgages, student loans, and car payments more expensive. The Fed buying Treasury debt to keep interest rates lower by increasing the money supply creates inflation, forcing families to stretch their scarce budgets further.
Every dollar the federal government spends on state programs is taken from the economy, where businesses and individuals could have put it to far more productive use. The ongoing budget fight in Washington makes one thing clear: states can’t count on federal funds forever.
Through the Department of Government Efficiency (DOGE), President Trump and Elon Musk have started freezing wasteful grants and unnecessary spending — steps that should have happened long ago.
Critics claim this is an overreach, but the real issue is decades of reckless spending leading to a $36 trillion national debt and a Congress unwilling to act.
The Keynesian idea that government spending fuels growth is a myth. Milton Friedman warned that spending is a cost, not a benefit. Every dollar Washington spends is taken from the productive private sector, where real wealth and innovation are created. More government spending crowds out private investment, reduces productivity, and leaves taxpayers with higher costs.
States that are the most dependent on federal aid — Louisiana, Alaska, and New Mexico, where over 50 percent of revenue to cover their budgets comes from Washington — also tend to have some of the weakest economies. The more states rely on federal funds, the less incentive they have to keep taxes low, cut regulations, and encourage private investment.
Trump’s spending freezes have upset politicians who depend on federal funds to prop up bloated budgets, but the real issue is that states allowed themselves to become dependent.
Excluding federal funds, state spending has grown by 61.1 percent from 2014 to 2023, far outpacing the 31 percent in compounded population growth plus inflation. But of course, much of that state spending increase is matched by as much, if not more, in federal funds, creating perverse incentives for states to spend more. But excluding federal funds from state spending over that decade helps to remove much of the increase in federal funds to states for those states that expanded Medicaid. Ultimately, had states kept their spending in check, they could have saved taxpayers $454 billion in 2023.
With Washington facing a growing debt crisis, states must act now to prepare for less federal funding.
That starts with transparency — understanding exactly how much money comes from Washington, where it goes, and which programs will be at risk when federal dollars dry up. Then, states must rein in spending, eliminate inefficiencies, and take back control over education, healthcare, and transportation so they are not at the mercy of federal strings.
Some states are already moving in the right direction.
Nearly a dozen — including Oklahoma, Louisiana, Iowa, Texas, and Florida — have launched a DOGE to expose waste and inefficiency. Oklahoma’s Division of Government Efficiency has already uncovered millions in unnecessary spending, providing accountability for spending with taxpayer money.
Long-term spending relief, however, requires Congress and state legislatures to act. While Trump and DOGE are taking steps, only Congress can make these cuts permanent. Without legislative action, future administrations could reverse spending freezes. Lawmakers who claim to be fiscal conservatives must prove it.
Some states have already shown that spending restraint works. Alaska, Colorado, North Dakota, Oklahoma, and Wyoming have kept their entire budget growth below inflation and population growth over the last decade, ensuring taxpayers aren’t overburdened. Others, like Louisiana, Massachusetts, and North Carolina, have slowed state spending growth below this key rate but remain too dependent on federal funds that grew more rapidly.
The Sustainable Budget Project by Americans for Tax Reform found that if governments had capped federal and state spending growth at population growth and inflation, taxpayers could have saved $2.5 trillion in 2023. That money could have been invested in businesses, used to create jobs, or saved for the future. Instead, excessive spending has made our lives more difficult.
Rising interest rates and national debt will eventually force Congress to reduce spending, leaving states with two painful choices: massive tax hikes or severe service cuts. There are no more excuses. Congress must spend less. To prepare for this inevitability, states must spend less, reject federal money with strings attached, and embrace free-market principles before it’s too late.
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Shocker! Syria Now Becoming Genocidal Hellhole
Video NSFW
Remember way back when all the “right” people were insisting that Syria’s al Qaeda terrorist “president,” who displaced Bashar al-Assad, had reformed from his al Qaeda ways and was going to lead his newly liberated country into an era of multicultural peace, love and understanding?
Yeah, you remember last week as well as I do.
Ah, the halcyon days when the good people who find Israel icky could look to a new hero and hope for a brighter future! Ahmed Hussein al-Sharaa was the new sheriff in town, and Syria would now be a safe and prosperous country run by a man the transnational elite was happy to take selfies with again.
Western leaders and intellectuals flocked to praise al-Sharaa and embrace him as the future of the Middle East or some similar nonsense. He was a REFORMED al Qaeda/ISIS/Nihilist and now wears a SUIT! The hosts of Britain’s most popular political podcast–former Tory MP Rory Stewart and his sidekick Alastair Campbell made a pilgrimage to be seen with him.
Dreamy.
Only the dream has predictably turned into a nightmare, as any sane person could have predicted. Syria is devolving into genocidal violence.
As I feared, this was the Libya trajectory. The West identifies a truly awful dictator and targets him for elimination. He is allied with the wrong people and is a violent authoritarian. Objectively speaking, the world would be a better place if he were gone.
Want to see what is happening in Syria? Let me warn you, the images are beyond disturbing. If you don’t have the stomach for it please, please do not click the videos. If you don’t need to see the proof with your own eyes, the summary is this: genocidal violence.
Want to see what is happening in Syria? Let me warn you, the images are beyond disturbing. If you don’t have the stomach for it please, please do not click the videos. If you don’t need to see the proof with your own eyes, the summary is this: genocidal violence.
And don’t buy the line some of the media are selling: this is not Assad regime fighters holding out or striking back. These are the Syrian rebels executing people for their religious differences. Christians are being massacred. Muslims from different sects. There is casual torture, rape, ritual humiliation.
It is an orgy of violence. Bodies are everywhere, and the terrorists are having a really great time of it. How nice.
Do I wish Syria were run by neither a sociopathic dentist ophthamologist who murders all his opponents OR an al Qaeda/ISIS terrorist with a penchant for mass murder of people? Yes, yes I do.
But that was never a choice. The Obama administration started this vicious civil war that has destabilized the Middle East, caused a refugee crisis that has destabilized Europe, and has now created yet ANOTHER Middle Eastern failed state that will remain a hellhole for generations and export violence around the world for decades.
Good job, guys. Really appreciate all you have done.
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