The case for saving Medicaid with Medicaid savings

Republicans in Congress are rightly looking to Medicaid’s out-of-control spending growth for possible savings to help preserve the 2017 tax cuts in what President Donald Trump hopes will be “one big, beautiful” reconciliation bill. 

If done right, those savings could also help save Medicaid as we know it. That means saving Medicaid for its intended recipients and saving Medicaid from being squandered on payments that are either implicitly or explicitly prohibited by law.

Medicaid was established to provide health insurance to low-income children, pregnant women, seniors, and the disabled. Today, more than 21 million out of a total of 71.3 million Medicaid enrollees aren’t among the program’s intended recipients, but are instead able-bodied, working-age adults without dependents. 

What’s worse, the federal government pays for 90% of the

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