States have gotten very good at using loopholes to circumvent the law. Chief among them is something called 'emergency Medicaid.'
, California froze new enrollment for most undocumented adults and announced new premiums for this group set to take effect in 2027. The state already spends some well beyond the intent of federal law.
They’re also fiscally irresponsible. The answer is that states have gotten very good at using loopholes to circumvent federal law. Chief among them is something called “emergency Medicaid” — a component of the program intended to provide urgent medical care to otherwise ineligible immigrants. Emergency Medicaid, as its name suggests, is supposed to be used only in extreme circumstances. But that isn’t how states have done things lately — and particularly not under former PresidentSUSIE WILES DIAGNOSED WITH ‘EARLY STAGE’ BREAST CANCER: TRUMP Until recently, states were rewarded for employing this legal workaround, because the federal matching rates for emergency Medicaid patients were actually higher than for traditional enrollees. Thankfully, the One Big Beautiful Bill Act , was originally designed as a safety-net program for the nation’s poorest citizens. Expanding it indefinitely, especially through legal gray areas and fiscal workarounds, risks undermining its fiscal future. Sally C. Pipes is president, CEO, and Thomas W. Smith Fellow in Health Care Policy at the Pacific Research Institute. Her latest book is
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