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Happy 15th Birthday, ACA
Fifteen years ago this month, President Obama signed into law the two bills that together make up the Affordable Care Act (ACA). It was, to borrow a phrase, a BFD. In a blog, on the occasion of a previous birthday, my colleague Joan Alker methodically laid out just how big a deal the ACA was…
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Medicaid Fraud: The Improper Use of Improper Payments
Welcome to another installment on the misuse of the Medicaid “improper payments” metric. This conversation began in 2018, then continued in 2020, 2022, and this year. For those just joining, Brian Blase of the Paragon Institute and his colleague, Rachel Greszler of the Economic Policy Innovation Center, have launched yet another misguided assault on federal…
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Medicaid Managed Care: The Big Five in Q4 2024
The “Big Five” earnings results for Q4 of 2024 are now in. The “Big Five” are the publicly-held companies that together control half of the Medicaid managed care market: Centene, CVSHealth/Aetna, Elevance Health, Molina Healthcare, and UnitedHealth Group. (There are five nonprofit Medicaid managed care organizations (MCOs) with significant regional or single-state market footprints, but…
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The Truth about Waste and Abuse in Medicaid
“States are abusing federal Medicaid policy. There is an enormous amount of waste, fraud and abuse in the program.” – Brian Blase, President, Paragon Health Institute, as reported in Stat (January 6, 2025) This falsehood is one premise for the proposals to cut federal Medicaid spending by $2.3 trillion (with a “t”) over the next…