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John Livingston

Our Medicaid System is Riddled with Fraud and Deceit

Where are the grown-ups? Where are our leaders?

In 2020, early in the Covid Political Pandemic, Congress increased the Federal Governments Medicaid “match”. As one of the conditions for receiving these extra monies, States cannot disenroll Medicaid beneficiaries who become ineligible. Only those that die, leave a State or request to be disenrolled are dropped off the rolls. Idaho has been identified as being the twelfth worse State for fraudulent Medicaid enrollments and billings. A very few cases have been prosecuted by Attorney General Wasden over the years. The beneficiaries of this abuse are providers and the insurance carriers. This boondoggle will continue until mid-July when the end of the Public Health Emergency” is officially scheduled to end. The Biden Administration wants to extend the Federal Emergency Order until mid-October. Is our Governor and State of Idaho Legislature going to allow this boondoggle to continue? Like we saw with our own Governor’s Emergency Order, the State and Federal Constitutions can be manipulated to facilitate the flow of money to large corporate interests. They in turn support politicians who are charged with regulating their businesses and controlling the flow of funds this gives back to their contributors many times over their contributions in “transfer payments” and subsidies.

Every dollar spent on ineligible Medicaid patients, or is misallocated or misappropriated by our legislature (there is a difference between allocation and appropriation), every up coded invoice sent by a provider and every false billing or false claim on a transfer subsidy, is money not spent on those most in need. Unemployment is at 3.3% in our State. The major reason for our low uninsured rate in Idaho is not because of Medicaid enrollments or high numbers of people enrolled on the Exchange. It is because people have jobs and can afford to pay for their own health insurance, or their employers can afford to pay. Inflation running at 8% while wage growth in Idaho has increased between 2-3 %. As the cost of government programs increases, and the tax burden on citizen’s increases. Real estate taxes in Ada County have gone up in some Zip Codes between 20-25%, the increasing taxes required to cover government programs will further “squeeze” voters. Again, the time to decrease taxes—Grocery and Property and individual State income tax is when people are employed, and the tax burden can be spread across more households.

Where are the grownups in State government? Politicians profess to be caring, empathetic and sympathetic. What they don’t do is require The Department of Health and Welfare to undergo independent outside signed partner’s audits on an annual basis. These audits need to be provided to the people of Idaho via their legislature. We should require the same type of audits on private and non-profit organizations that receive $100million/year of transfer payments. Unfortunately these guardians of our tax dollars are asleep at the switch and they are complicit when they provide cover to those who contribute to their campaigns and are the beneficiaries of such largesse. Where are the grown-ups? Where are our leaders?

Integrity in State government is hard to find. Corruption is so ubiquitous and has been part of the “order of the day” that practitioners of the art don’t even see it for what it is. Integrity is defined as an allegiance to a moral code, not to a process where those who they are charged with regulating, then give campaign contributions to those in the executive and legislative branches of government (the regulators). The lobbyist corporatists that facilitate and participate in the transactions of government, add no value to the lives of the people of Idaho. Money going to the corporate monopolies in our state. The last CEO at Luke’s made $18million his last two years of employment according to IRS Forms 990, which is money out of the pockets of taxpayers and small business. $18million could go a long way taking care of the needs of a lot of people currently living on the margins. As the moral foundations of our culture are being shaken, we need people in State Government and in the private sector to stand up to such malfeasance. Where are the grownups? Where are our leaders?

We need leaders—Governors, and legislators who are willing to stand up against the status quo of crony collusion. Compare what Governor DeSantis is doing in Florida to Governor Brad Little. I hope our new speaker of the House—Mike Moyle is my choice, will be able to confront the mismanaged government budgetary process that hides behind The Joint Appropriations Finance Committee (JAFC) before that process and that Committee becomes an extension and agent of the Federal government. Over 50% of the State Medicaid $4.6billion budget already comes from the Feds and Education is not far behind. Who will be our leaders?

If we want Idaho to stay Idaho, we must begin to confront the establishment corporatists. Enough already. We need leaders with integrity and an allegiance to the people and not to the lobbyist corporatists and out of State money bundlers. I certainly know who not to vote for. I know who not only supports but is supported by the status quo. In the coming months I hope to clarify who we should vote for and why.

We need grownups in State Government. We need leaders.

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