Audit Reveals Medicaid Spending Increases Under Biden Administration

What it is

A recent Government Accountability Office (GAO) report has highlighted significant increases in Medicaid spending under the Biden administration, raising concerns about fiscal responsibility and the expansion of welfare programs. The study indicates that changes in federal guidance have allowed states to increase their Medicaid waiver spending, potentially costing taxpayers billions.

Why it matters

• The study indicates that changes in federal guidance have allowed states to increase their Medicaid waiver spending, potentially costing taxpayers billions
• This approach aimed to prevent states from inflating their spending limits by referencing years of higher expenditures
• The GAO report noted that this guidance resulted in a reduction of total spending limits for waivers submitted by Tennessee and New York by $232.6 billion, with the federal share amounting to $122.5 billion
• However, the Biden administration revised this guidance, allowing states to establish base years using a combination of actual and historical spending
• This change has reportedly increased the limits on Medicaid spending by $28.4 billion for waivers submitted by Arizona, Massachusetts, and Washington state, with a federal cost implication of $16.6 billion
• This shift raised the spending limits for Arizona, Massachusetts, and Washington state by an additional $8.5 billion, with $4.3 billion potentially impacting federal expenditures

Key facts

• The study indicates that changes in federal guidance have allowed states to increase their Medicaid waiver spending, potentially costing taxpayers billions

Timeline & recent coverage

• See related posts on our site; this explainer updates when new reporting appears
• For deeper background, explore the sources below

Primary sources

• https://www.gao.gov/assets/gao-25-107445.pdf
• https://www.medicaid.gov/federal-policy-guidance/downloads/smd18009.pdf
• https://www.medicaid.gov/federal-policy-guidance/downloads/smd24003.pdf

Further reading & references

• (Additional background links will appear here as we cover this topic)