Marc Goldwein
tl;dr -- States are colluding with providers to rip of the federal government and collect far more than their intended Medicaid match. The legalized money laundering has to stop. https://www.crfb.org/blogs/hundreds-billions-medicaid-savings-financing-schemes
Igor Bobic
Cassidy says it’s time to “rethink” how Medicaid expansion federal cost share works: “If the federal contribution supposed to be 60% and the state contribution 40%, I would suspect, on average, right now, the federal contribution is like 85% so think about how much, how many billions, if trillions, that represents, of states withdrawing their share for what's going on. And so folks say, ‘Wait, federal government's cutting.’ The states have been cutting. They are not contributing. So I think that there has to be an awareness, unless you just want to completely turn the program over the federal government, that the states need to do something to uphold their side of this bargain, and that's not happening now, and they're using a variety of mechanisms by which they pass that cost off to the federal government. Now, some of it's legal. In fact, it's all technically legal, but it is shirking the state's contribution. So I think we need to rethink how this works.”