Why reformers must win the ‘big, beautiful’ GOP Medicaid battle

If Republicans are going to pass President Donald Trump’s “big, beautiful” tax- and spending-cut bill, they’ll have to have to reckon with a hard truth: Medicaid is not sacrosanct. 

At least, not the path that Democrats had set for the program in the Obama and Biden years — a path of rapid growth and ever-expanding coverage.

Indeed, slowing Medicaid’s growth is vital not just to keep the “big bill” numbers balanced, but to keeping the program faithful to its actual purpose: ensuring health care for the poor.  

From the ObamaCare law onward, Democrats national and state have messed with Medicaid to push, shove, sneak and creep the country ever closer toward full-on socialized medicine. 

That’s meant vastly expanding the rolls to include people too young and too rich, people the program was never meant to serve. 

Thanks to Obama’s Affordable Care Act, the federal government pays for 90% of the cost of “prime age” state enrollees in the program; the “expansion” part of Barack Obama’s signature law was a bribe to Dem constituencies.

It’s provided a monstrous incentive to swell the ranks, including with people above the income limit: In the Empire State, for example, the data suggests that as many as 3 million over-earners use the program. 

This failure directly contradicts the point of Medicaid, which was to cover care for the poor (as Medicare did for the elderly), not for everyone in every state, no matter their age and earning ability.  

The slowdown has to happen, including a federal push for states to get adults who are too young and too-rich off the rolls. 

To get there, of course, Republicans will have to face down an avalanche of negativity from congressional Dems: The endless expansion of Medicaid has been a pet project of theirs for two decades; the old guard and the young bloods are equally committed to it. 

Naturally, most of the press is already starting to play along, with straight-up propaganda attacking these necessary reforms. 

The truly tricky part, however, is going to be for Trump and Speaker Mike Johnson to turn around the GOPers already squawking, like Nebraska Rep. Don Bacon, who’s drawn a public redline of no more than $500 billion in reductions.

We get it: Many politicians don’t want their fingerprints anywhere near anything that even remotely resembles an entitlement cut.

But any Republicans who flinch at undoing Democrats’ stealth moves to lock in an ever-expanding welfare state might as well quit politics completely.