Bureaucrats Undermine Trump's COVID-19 Plan, Bolstering Joe Biden

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At a time when America’s hospitals are growing more crowded by the day, and shortages of critical medical supplies are reaching dangerous territories, the coronavirus epidemic has vindicated core portions of President Trump’s agenda. More Americans than ever are recognizing that the U.S. cannot become the healthcare system for the world and that strong borders protect the interests of the American people. A significant percentage of the public has also joined the president in questioning why the country outsourced the production of critical medicines and supplies to China. 

Democrat front-runner Joe Biden knows the danger this poses to his election prospects, and he is looking for any vulnerability within the White House’s current COVID-19 relief plans that he can promote to get ahead. 

Unfortunately, while President Trump is signing legislation and issuing emergency declarations that provide deregulatory support to the states’ Medicaid programs, bureaucrats in the Centers for Medicare and Medicaid Services (CMS) continue pushing red tape to block much of the added flexibility. If allowed to move forward, their actions will comprise the success of the president’s coronavirus deterrence strategy – hurting the administration politically, harming taxpayers, and having severe ramifications for the safety and well-being of the American people overall.

The troubling mandates in question all come from within the Medicaid Fiscal Accountability Rule (MFAR), a misnamed massive regulation proposed in November that the agency continues to stand behind.  Biden has explicitly called out MFAR in his coronavirus rapid response plan, stating that he supports the bipartisan efforts to stall its implementation. It is easy to understand why. The regulation represents inexcusable, dangerous regulatory overreach, and opposing it is an easy political victory.

MFAR’s pages upon pages of new federal government edicts will impose caps and increased micromanagement over the individual states’ Medicaid payments to doctors and hospitals, all while subjecting state Medicaid budgets to the approval of federal bureaucrats.

The vast majority of state Medicaid budgets are already drastically underfunded. Because of the COVID-19 crisis, their budgetary issues are already getting worse. Most states already have dangerous shortages of protective masks, ventilators (which often mean life or death in coronavirus cases), and doctors themselves. And yet, CMS’ MFAR would add another layer of bureaucracy that imposes significant delays to their COVID-19 response efforts at best and hamstrings their Medicaid budgets and ability to care for their residents entirely at worst. Studies have already shown that the new regulation will likely lead to significant state tax increases to make up for the shortfall caused by this bureaucratic interference. That’s fiscal irresponsibility, not fiscal accountability.

Past and present red-state governors, like Bobby Jindal (R-La.) and Charlie Baker (R-Mass.), have already come out vehemently against MFAR, as did all 36 members of the Texas congressional delegation in a March 10 letter they sent to CMS. They know healthcare and entitlement law explicitly afford the states substantial authority over determining what qualifies as Medicaid spending within their borders and that assaulting federalism in this manner – in a crisis where timing is everything – can mean life or death for many victims. 

It’s not surprising that CMS is still moving forward with a rule that will impose even more upward regulatory pressure on the states’ Medicaid systems. Last week, hospital representatives reported being very disappointed with a meeting they had with the agency's administrator about COVID-19. It’s clear the agency doesn’t share the rest of the country’s sense of concern and urgency for the crisis as it seeks to derail the president’s Medicaid flexibility plans through this sweeping regulatory power-grab.

There is only one person in the country that benefits from CMS’s continued push on MFAR, and that’s Vice President Biden, who needs a political talking point to exploit in the administration’s otherwise sound response work.

Medicaid would certainly benefit from more fiscal accountability, and that can be achieved through block-granting — replacing the states' funding matches for Medicaid from the federal government with fixed, set grants. Centralizing American healthcare even further in a way that endangers both patients and state taxpayers is the last thing anyone should want, especially at this time and under these conditions. Here’s hoping that the White House intercedes and demands that CMS pull back this disastrous, big-government regulation that goes against all of the legislation and orders the president has signed to combat this epidemic. The health and safety of the public will depend on it.

Alex Cougar, M.D., holds a PhD in social science from Columbia University. He received a commendation from the President of the United States for his work in alternative medicine.

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