<a href="https://www.dailywire.com/topic/idaho" target="_blank" rel="noopener">Idaho</a> Republican Governor Brad Little signed a bill into law on Wednesday that prohibits taxpayer dollars from being used to pay for transgender surgeries and procedures.
The <a href="https://legislature.idaho.gov/sessioninfo/2024/legislation/h0668/" target="_blank" rel="noopener">measure</a>, which easily passed both the state House and Senate, prohibits <a href="https://www.dailywire.com/topic/idaho" target="_blank" rel="noopener">Idaho</a> public dollars from going toward transgender procedures and stipulates that those procedures cannot be done in a government owned building or properties. It passed the House by a vote of 58-11 and the Senate by a vote of 26-8.
“The proposed legislation ensures taxpayer dollars are not used to provide medical treatment or surgeries for the purpose of changing the appearance of a person&#8217;s sex in a way that is not consistent with their biological sex,” a <a href="https://legislature.idaho.gov/wp-content/uploads/sessioninfo/2024/legislation/H0668SOP.pdf" target="_blank" rel="noopener">statement</a> of purpose on the legislation said. &#8220;These medical and surgical interventions can cause irreversible physical alterations; and some render the patient sterile or with lifelong sexual dysfunction, while others mutilate healthy body organs.&#8221;
Included in the <a href="https://legislature.idaho.gov/wp-content/uploads/sessioninfo/2024/legislation/H0668.pdf" target="_blank" rel="noopener">law</a> is a prohibition of using Idaho Medicaid funds for transgender procedures, as well as blocking doctors employed with the government from performing the procedures in the scope of their government work.
Little, whose signing of the measure was first <a href="https://dailycaller.com/2024/03/28/idaho-gov-ban-taxpayer-funding-sex-change-procedures/" target="_blank" rel="noopener">reported</a> by the Daily Caller, was widely expected to support the measure after it made its way through the legislature.
&#8220;If the government continues to send our tax dollars towards false answers to real questions, we do a terrible disservice to our citizens,&#8221; <a href="https://www.kivitv.com/downtown-boise/governor-brad-little-signs-bill-that-bans-public-funds-used-for-gender-affirming-care#:~:text=BOISE%2C%20Idaho%20—%20On%20March%2027,for%20any%20gender%2Daffirming%20care." target="_blank" rel="noopener">said</a> Senator Ben Toews during debate on the bill.
The measure was opposed by Democrats and liberal groups like the ACLU, but backed by conservative organizations like the Alliance Defending Freedom.
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“There are only two sexes—male and female—and public funds shouldn’t be used to deny this basic truth,” said ADF Senior Counsel Matt Sharp in a <a href="https://adfmedia.org/press-release/idaho-law-ensures-public-funds-do-not-promote-dangerous-life-altering-procedures" target="_blank" rel="noopener">statement</a> praising Little’s decision. “Now and always, our loved ones deserve the loving embrace of family members who guide them toward this reality, along with access to safe and effective counseling. People should not be subjected to harmful—often irreversible—drugs and surgeries that block healthy development, alter hormonal balances, and remove healthy organs and body parts.”
“Idaho, through the leadership of sponsors Rep. Julianne Young, Rep. Bruce Skaug and Sen. Ben Toews and with the support of the Legislature and Gov. Little, now rightly joins a growing number of states that have enacted similar protections from these experimental procedures and bad science,” Sharp added.
While nearly two dozen states have banned transgender procedures on children, only <a href="https://www.nbcnews.com/nbc-out/out-news/idaho-considers-ban-using-public-funds-facilities-transgender-care-rcna143870" target="_blank" rel="noopener">around</a> 10 have blocked state funds from being used to fund the procedures on others.

Conservative Political Action Conference Speakers

Idaho Governor Signs Law Blocking Taxpayer Funding For Trans Surgeries

Idaho

Medicaid

Social Issues

Transgender

transgender surgery

U.S.

Senator Bill Cassidy (R-LA) introduced a bill on Thursday that would block states from being able to use federal funding to subsidize state programs that provide health care for illegal immigrants. 
The <a href="https://www.cassidy.senate.gov/wp-content/uploads/2024/01/Portect-Medicaid-Act-2024.pdf" target="_blank" rel="noopener">legislation</a>, known as the “Protect Medicaid Act,” would prevent federal Medicaid “funding for the administrative costs of providing health benefits to individuals who are unauthorized immigrants.&#8221; Co-sponsors of the legislation include Sens. Marsha Blackburn (R-TN), John Barrasso (R-WY), Roger Wicker (R-MS), and Cindy Hyde-Smith (R-MS). 
According to Cassidy’s office, the bill “prohibits federal money from being spent on administering state Medicaid benefits paid for by American citizens to noncitizens. If a state chooses to give Medicaid benefits to illegal residents, the bill ensures that state does so entirely on its own dime, without any costs to taxpayers in other states.”
The legislation comes as California <a href="https://apnews.com/article/california-medicaid-expansion-undocumented-immigrants-34d8deb2186e9195b253f499e81a3d77" target="_blank" rel="noopener">expands</a> its Medicaid program to provide free health care for about 700,000 illegal immigrants in the state. The expansion is projected to cost the state more than $3 billion. Oregon has a similar program on the books. 
“Medicaid for migrants is a magnet for more illegal immigration,” Cassidy said. “This is terrible public policy for California citizens who depend on Medicaid, middle-class families paying taxes, and state debt. Taking care of the most vulnerable Americans should be our priority. Attempting to provide health care to everyone around the globe for free is not possible or feasible. Compassion that cannot be sustained is not compassion.”
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The bill would also mandate that the inspector general for the Department of Health Care and Human Services produce a report on states that fund health care for illegal immigrants. 
The report would provide, “a description of States’ methods of financing State programs that provide health benefits to noncitizens who are ineligible for medical assistance due to not having a satisfactory immigration status, including through the increased use of provider taxes and intergovernmental transfers to finance the non-Federal share of expenditures under the State Medicaid program for medical assistance provided to individuals who are not so ineligible.”
Blackburn said that programs to provide state funding for health care for illegal immigrants were unfair and jeopardized the health care of Americans.
“Tennesseans and the American people do not want their tax dollars subsidizing Medicaid for illegal immigrants,” she said. “Not only is it unfair to hardworking citizens, but it incentivizes more illegal immigration and puts the care of millions of Americans on the back burner.”
The legislation comes as the U.S. southern border has been inundated with a surge of illegal immigrants. In December, Border Patrol recorded about 300,000 foreign national encounters, an all-time high. A report from last year <a href="https://www.dailywire.com/news/migrant-crisis-could-cost-taxpayers-451-billion-house-gop-report-says" target="_blank" rel="noopener">estimated</a> that illegal immigration could cost American taxpayers up to $451 billion.

Migrant caravan regroups in Mexico after government promises of papers falls through

Senators Introduce Bill To Bar States From Using Federal Dollars To Subsidize Health Care For Illegal Immigrants

California

Congress

Health Care

Illegal Immigration

Oregon

Politics

The <a href="https://www.dailywire.com/topic/maine" target="_blank" rel="noopener">Pine Tree State</a> has a poverty rate of about 10.6% but nonetheless, the ol&#8217; moonbats in Maine want to bring in more impoverished people from around the globe by offering taxpayer-funded healthcare to even more illegal aliens over the age of 21.
Maine has become a bit of a <a href="https://cis.org/Arthur/Migrant-Crisis-Portland-Maine" target="_blank" rel="noopener">hotspot for illegal aliens</a>, many of whom travel to Portland, the state&#8217;s largest city. In turn, Portland has spent the last year in financial ruin, with social services strained while city leaders described their situation as &#8220;<a href="https://www.dailywire.com/news/maines-largest-city-in-dire-situation-due-to-unprecedented-volume-of-migrants-arriving-from-southern-border" target="_blank" rel="noopener">dire</a>.&#8221;
To help remedy the situation, Democrats in the state&#8217;s capital don&#8217;t want to end all that welfare — thereby disincentivizing &#8220;noncitizens&#8221; to come to Maine — but instead expand government health care programs afforded to all illegal aliens.
The bill is officially known as “An Act to Improve the Health of Maine Residents by Removing Exclusions to the MaineCare Program.&#8221; All that really means is that foreign nationals making below a certain income will be able to apply for Maine&#8217;s Medicaid program, The Maine Wire <a href="https://www.themainewire.com/2023/03/medicaid-for-illegal-aliens-bill-moves-forward-in-maine/" target="_blank" rel="noopener">reported</a>.
House Speaker Rachel Talbot Ross (D-Portland) introduced the bill, and it passed a legislative hurdle Tuesday afternoon. If it is signed into law, which Maine Wire says seems likely, it will go into effect in 2024.
Current price projections for the program are based on a guesstimate of how many illegal aliens, asylum seekers, and other legal noncitizens are in Maine. Undoubtedly though, that cost would rise once future illegal aliens learn they can get the free benefits.
In support of the legislation, economic policy analyst for the Maine Center for Economic Policy James Myall argued that &#8220;healthy Mainers are productive Mainers and that by assisting new Mainers with access to health care we’ll be ensuring they are able to contribute to our collective well-being to the fullest extent through the economy.&#8221;
Well, the problem is they aren&#8217;t Mainers. They aren&#8217;t even American citizens. And this will only attract more illegal immigrants to travel to Maine.
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The bill comes as America experiences its worst illegal immigration crisis ever under President Joe Biden as his administration all but neglects the open southern border.
Consider that the state of Maine has a population of roughly 1.39 million.
Since January 2021, the Biden administration has allowed at <a href="https://www.foxnews.com/us/border-agents-confirm-1-2-million-gotaway-migrants-biden-administration" target="_blank" rel="noopener">least 1.2 million &#8220;</a>known gotaways&#8221; — or illegal aliens not stopped by border patrol. That number does not include the hundreds of thousands, possibly millions, of &#8220;unknown gotaways.&#8221; Nor does it include the number of &#8220;asylum seekers&#8221; — many of whom first came to the country unlawfully, then declared asylum on U.S. soil as the law allows — that have flooded America since Biden was elected.
Those numbers are expected to continue unabated, and the federal government cannot even definitively say whether or not Mexico is a reliable ally in the fight against illegal immigration.
What&#8217;s going to happen to Maine&#8217;s already beleaguered welfare system once it opens up free healthcare to those millions of individuals, all on the taxpayers&#8217; dime? It won&#8217;t be a pretty sight for anybody.
The views expressed in this piece are the author’s own and do not necessarily represent those of The Daily Wire.
RELATED: <a href="https://www.dailywire.com/news/pure-dumb-luck-leads-to-arrest-of-17-illegal-aliens-in-maine-bust-of-elaborate-human-smuggling-scheme" target="_blank" rel="noopener">Pure Dumb Luck Leads To Arrest Of 17 Illegal Aliens In Maine</a>

(DenisTangneyJr via Getty Images) (Stringer/picture alliance via Getty Images)

More Taxpayer-Funded Freebies On The Table For Illegal Aliens In Maine

Immigration

Maine

California Gov. Gavin Newsom wants to use federal healthcare funds to cover at least six months of rent for the state&#8217;s disproportionately large homeless population and for those on the brink of losing their housing.
Newsom recently asked President Biden to approve a new program called &#8220;transitional rent&#8221; under Medi-Cal, the state&#8217;s version of Medicaid. According to <a href="http://latimes.com/california/story/2023-03-20/prescription-for-housing-california-wants-medicaid-to-cover-6-months-of-rent">The Los Angeles Times</a>, state officials modeled the program after similar federally approved programs in Oregon and Arizona that would pay up to six months of rent or temporary housing for low-income enrollees who rely on the state&#8217;s healthcare.
&#8220;I&#8217;ve been talking to the president,&#8221; Newsom told KHN. &#8220;We cannot do this alone.&#8221;
Newsom and proponents of the aid argue temporarily covering rent for homeless people would save taxpayers money rather than paying more into California&#8217;s institutional care in hospitals, nursing homes, and jails.
Bruce Alexander, a Centers for Medicare &amp; Medicaid Services spokesperson, declined to disclose to The Times whether the federal government would approve the request.
<a href="https://nashp.org/how-states-use-federal-medicaid-authorities-to-finance-housing-related-services/#:~:text=While%20Medicaid%20cannot%20pay%20for,to%20find%20and%20sustain%20housing.">The National Academy for State Health Policy</a> writes Medicaid cannot directly pay for housing development or rent. However, it can support services for enrollees to find and sustain housing.
The state&#8217;s program has already helped low-income patients with rental security deposits for homeless people and those facing eviction through a federally approved program called CalAIM, which The Times reported has transformed Medi-Cal.
Homelessness in California continues to grow, leading the nation with the largest population for over a decade, according to the <a href="https://www.ppic.org/blog/homeless-populations-are-rising-around-california/#:~:text=As%20of%202022%2C%2030%25%20of,%3B%20233%2C832%20in%20the%20US).">Public Policy Institute of California</a>.
Last year, the think tank estimated 30% of the 233,832 people in the United States experiencing homelessness live in California based on the federal government&#8217;s imperfect &#8220;Point in Time&#8221; count on the nation&#8217;s homeless population. However, Newsom admitted those numbers likely don&#8217;t reflect the state&#8217;s official count, acknowledging it is much higher than tallied.
Researchers at the institute reported state data indicating that 5% of Medi-Cal patients account for 44% of the program&#8217;s spending. Many patients experience some form of homelessness and frequently visit emergency rooms, covered mainly by the state health program.
&#8220;California emergency departments (EDs) treated about 143,000 people experiencing homelessness in 2019, according to hospital discharge records,&#8221; the report <a href="https://www.ppic.org/publication/policy-brief-how-hospital-discharge-data-can-inform-state-homelessness-policy/">reads</a>. &#8220;Almost half of homeless patients visited the ED four or more times in the year.&#8221;
Insurers argue mixing healthcare funds with housing would not save the state money, while healthcare officials point to California&#8217;s affordable housing crisis as another significant issue, which Newsom has publicly acknowledged.
&#8220;We can design incredible Medicaid policies to alleviate homelessness and pay for all the necessary supportive services, but without the adequate housing, frankly, it&#8217;s not going to work,&#8221; Dr. Margot Kushel, director of the University of California-San Francisco&#8217;s Center for Vulnerable, told The Times.
If authorized by the Biden administration, homeless people who qualify for the limited aid in California could begin receiving rent payments by 2025, eventually costing the state approximately $117 million annually after it&#8217;s up and running.
According to The Times, 11,000 people have already enrolled in Medi-Cal housing services.

Homelessness

California Asks Biden Administration To Cover Six Months Of ‘Transitional Rent’ For Homeless With Medicaid

California Asks Biden Administration To Cover Six Months Of 'Transitional Rent' For Homeless With Medicaid 

Biden Administration

Executive

Gavin Newsom

Nevada’s Democratic state lawmakers plan to introduce a bill giving Medicaid to <a href="https://www.dailywire.com/topic/illegal-immigration" target="_blank" rel="noopener">illegal immigrants</a>, at an estimated initial cost of $78.5 million.
The proposed legislation comes from State Sen. Fabian Doñate, Co-Majority Whip of the Senate Democrats. Doñate issued the cost estimate during a Wednesday press conference; however, he implied that the extension could end up being more, since there are no exact data on illegal immigrant totals in Nevada and folks are “scared” to admit their immigration status. The bill — titled the “Nevada Health Opportunities, Planning, and Expansion Act,” or “HOPE Act” for short — has yet to be filed.
Doñate first disclosed the Medicaid expansion plan during a press conference on the opening day of Nevada’s legislative session last month through the Latino Legislative Caucus, which he chairs. The proposed extension of benefits to illegal immigrants falls under the caucus’ legislative priorities for this session.
<blockquote class="twitter-tweet">
The NLLC is proud to push forward towards helping serve our communities and fight for the rights of our fellow Latino brothers and sisters. 
_____ <a href="https://t.co/wihfxVvOx8">pic.twitter.com/wihfxVvOx8</a>
— Nevada Latino Legislative Caucus (@NVLatinoLeg) <a href="https://twitter.com/NVLatinoLeg/status/1622755534964391936?ref_src=twsrc%5Etfw">February 7, 2023</a></blockquote>
In a Wednesday press conference on the act, Doñate called the legislation “fiscally responsible” and “the right thing to do.” Doñate then invited two illegal immigrant activists to testify on behalf of the proposed legislation.
That illegal immigrant activist, Samuel Cano, explained that the legislation means a lot to him because he’s currently an “undocumented” nursing student at the College of Southern Nevada (CSN). Cano, who said he entered the country illegally around four years old, has also served in student leadership at CSN, leading as a campus senator for the Associated Students of the College of Southern Nevada (ASCSN).
Cano complained that he’s unable to obtain health insurance because he’s an illegal immigrant. Cano said that this limitation prevents him from achieving greater success in his intended career as a nurse.
“This is a major setback for me, and it is preventing me from achieving my goal. It is heartbreaking to know that the only thing that is standing between me and my dream is something as basic as health care,” said Cano.
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Cano has been involved in other activist efforts as of late. Earlier this month, Cano rallied with the Nevada Environmental Justice Coalition at the Nevada State Capitol to make water, clean air, and a “clean and healthy environment” into constitutional rights within a “<a href="https://www.leg.state.nv.us/App/NELIS/REL/82nd2023/Bill/9946/Text" target="_blank" rel="noopener">Green Amendment</a>.” The proposed constitutional amendment would also preclude state lawmakers from taking any action that would degrade, diminish, or deplete the environment.
Rico Ocampo, an illegal immigrant activist with the nonprofit Make the Road Nevada, said that the United States failed him as a child because his family couldn’t obtain insurance after his older brother was diagnosed with terminal pancreatic cancer. (Ocampo’s bio on Make the Road Nevada lists his brother as younger, not older). Despite receiving financial aid from social workers, Ocampo’s family purportedly lost their home and faced hundreds of thousands of dollars in medical debt.
“We didn’t qualify for Medicaid because of our immigration status. The health care system failed us, and we were left to bear the financial and emotional burden of Carlito’s [inaudible] on our own,” said Ocampo. “He died as an undocumented person, a tragic reminder of how the country that I call home will gladly take our labor but deny our humanity.”
Other caucus members include Majority Floor Leader Sandra Jauregui, Assemblywomen Elaine Marzola, Selena Torres, Bea Duran, and Cecilia González, and State Sens. Edgar Flores and Dina Neal — all Democrats.
Democrats hold a majority in both Nevada’s House and Senate: 13 members in the 21-member Senate, and 28 members in the 42-member House. Nevada Governor Joe Lombardo is a Republican. Should Lombardo veto the bill while the legislature is still in session, the legislation would require a two-thirds vote in both the House and Senate to override. If the legislature is no longer in session, the bill would return the following session.

EAE198AF-1ED9-4003-8011-8FA89F49B427

Nevada Democrats Plan To Give Medicaid To Illegal Immigrants, Estimate $78.5 Million Cost

Nevada

Medicaid enrollment is expected to hit the 100 million mark soon, according to a new report.
The milestone will likely be reached within the next 75 days, a new project from the Foundation for Government Accountability (FGA) revealed.
“For years, FGA has been warning about the rising number of people on government welfare programs. Now, we’re nearing a grim milestone — nearly one-third of the country will be on Medicaid,” <a href="https://thefga.org/press/fga-launches-countdown-clock-to-100-million-on-medicaid/" target="_blank" rel="noopener">said</a> Hayden Dublois, FGA Data and Analytics Director.
<blockquote class="twitter-tweet" data-width="500" data-dnt="true">
As Americans count down to the new New Year, we have our eye on another countdown&#8230;
100 million individuals on Medicaid in 75 days. This is unsustainable, and the clock is ticking.
SEE IT IN REALTIME: <a href="https://t.co/Y2tR94L2ac">https://t.co/Y2tR94L2ac</a> <a href="https://twitter.com/hashtag/medicaid?src=hash&amp;ref_src=twsrc%5Etfw">#medicaid</a> <a href="https://twitter.com/hashtag/health?src=hash&amp;ref_src=twsrc%5Etfw">#health</a> <a href="https://twitter.com/hashtag/work?src=hash&amp;ref_src=twsrc%5Etfw">#work</a> <a href="https://t.co/w8jCftjpCw">pic.twitter.com/w8jCftjpCw</a>
&mdash; The FGA (@TheFGA) <a href="https://twitter.com/TheFGA/status/1608463549692510209?ref_src=twsrc%5Etfw">December 29, 2022</a></blockquote>
<script async src="https://platform.twitter.com/widgets.js" charset="utf-8"></script>
“Our research and data show as welfare enrollment increases, workforce participation decreases. We’re in the midst of a nationwide workforce crisis, yet the Biden administration is pushing policies to entice people into government dependency at record levels while limiting opportunities to achieve the America Dream,&#8221; he added.
The non-profit group explained in a press release that the rapid growth in enrollment is primarily due to the federal government’s continued extension of the COVID-19 public health emergency. While the emergency is in effect, states receive extra Medicaid funding on the condition that everyone enrolled remains locked into the program.
The program has added an additional 24 million Americans to Medicaid, the FGA stated. This number includes more than 21 million people otherwise unable to qualify because they earn too much money or are otherwise ineligible.
“The pandemic-era policy keeping more than 21 million ineligible enrollees on Medicaid is costing taxpayers more than <a href="https://www.wsj.com/articles/congress-healthcare-malpractice-medicaid-omnibus-bill-republicans-democrats-11671648241?mod=opinion_lead_pos4" target="_blank" rel="noreferrer noopener">$16 billion per month</a>. Despite the recently enacted legislation allowing states to redetermine eligibility beginning in April, the Biden administration is slow walking the process and hoping states will be sluggish to act,” Dublois said in the press release.
“In approximately 76 days, 100 million people will be on Medicaid. States should begin preparing now so that they can remove the millions of ineligible enrollees and reclaim program integrity as quickly as possible,&#8221; he concluded.
As of November, <a href="https://www.kff.org/medicaid/issue-brief/status-of-state-medicaid-expansion-decisions-interactive-map/" target="_blank" rel="noopener">39 states and Washington, D.C</a>., have adopted Medicaid expansion that allows additional low-income people to qualify. In addition, the American Rescue Plan Act offered additional incentives in 2021 for even more expansion.
The Biden administration has highlighted Medicaid expansion as a major reason for the nation&#8217;s uninsured rate falling to a record low of 8% this year. Approximately 5.2 million people – including 4.1 million adults ages 18-64 and 1 million children ages 0-17 – have gained health coverage since 2020, according to an August <a href="https://www.hhs.gov/about/news/2022/08/02/new-hhs-report-shows-national-uninsured-rate-reached-all-time-low-in-2022.html#:~:text=Today%2C%20the%20U.S.%20Department%20of,Harris%20Administration%20in%20January%202021." target="_blank" rel="noopener">report</a> by the Department of Health and Human Services (DHS).
The agency noted in its full <a href="https://aspe.hhs.gov/sites/default/files/documents/77ba3e9c99264d4f76dd662d3b2498c0/aspe-ib-uninsured-aca.pdf" target="_blank" rel="noopener">report</a> that administrative data from late 2021 and early 2022 &#8220;show a record-high number of people with coverage related to the Affordable Care Act (ACA) – with more than 35 million people estimated to be enrolled in the Medicaid expansion, Basic Health Program, or Marketplace coverage.&#8221;
The Families First Coronavirus Response Act (FFCRA) of 2020 required states, starting in March 2020, to suspend Medicaid eligibility terminations and maintain coverage for nearly all existing enrollees, in order to receive a 6.2% increase in their Federal Medical Assistance Percentage (FMAP). The report stated that the continuous coverage requirement was the &#8220;primary driver&#8221; behind Medicaid growth during the pandemic.

Mature adult woman in medical consultation with female doctor – stock photo

Medicaid Enrollment To Hit 100 Million, Include Nearly One-Third Of Americans

Health

Health Insurance

Speaking at a Fortune CEO conference on Thursday, West Virginia Democratic Senator Joe Manchin acknowledged the nation is suffering from “crippling debt” and suggested that changes be made to entitlement programs such as Social Security and Medicaid.
In 2022, major entitlement programs including Social Security, Medicare, Medicaid, Obamacare, and other health care programs will <a href="https://federalbudgetinpictures.com/where-does-all-the-money-go/">reportedly eat up</a> nearly half — 49% — of all federal spending.
“We cannot live with this crippling debt,” Manchin said, according to <a href="https://www.bloomberg.com/news/articles/2022-11-03/manchin-wants-deal-on-debt-social-security-medicare-and-medicaid#xj4y7vzkg" target="_blank" rel="noopener">Bloomberg</a>.  “If we can’t come to grips of how we face the financial challenges this country has, then we’re all going to be paying a price that we can’t afford.”
According to the Social Security Board of Trustees, Social Security will go bankrupt in 2034. “That means anyone 55 or younger today won’t receive a single full benefit, and most current retirees will be subject to 23% benefit cuts—an average loss of $4,400 per year,” Rachel Greszler of The Heritage Foundation <a href="https://www.heritage.org/social-security/commentary/social-securitys-unfunded-obligations-getting-worse" target="_blank" rel="noopener">noted</a>, adding, “Taking measures like gradually shifting to a flat benefit, slowly raising the retirement age and indexing it to life expectancy, using a more accurate inflation measure, and eliminating work disincentives would protect and improve Social Security.”
Manchin’s comments fly in the face of Vermont Senator Bernie Sanders, who <a href="https://www.nytimes.com/2022/11/03/business/biden-debt-limit-shutdown.html" target="_blank" rel="noopener">told</a> The New York Times that Democrats should raise the debt limit quickly in case the GOP wins the House or Senate, claiming the GOP would cut Social Security, Medicare and Medicaid.
The United States national debt passed $31 trillion for the first time ever in early October, according to <a href="https://fsapps.fiscal.treasury.gov/dts/files/22100300.pdf">data</a> from the Treasury Department.
“The newest debt milestone <a href="https://www.usdebtclock.org/" target="_blank" rel="noopener">implies</a> over $93,000 in liabilities per citizen and nearly $247,000 per taxpayer,” <a href="https://dailywire.com/news/national-debt-surpasses-31-trillion-for-the-first-time-republicans-and-democrats-both-to-blame/" target="_blank" rel="noopener">The Daily Wire</a> pointed out, adding, “Policies enacted by President Joe Biden will contribute more than $4.8 trillion in new deficit spending between 2021 and 2031, according to an <a href="https://www.crfb.org/blogs/biden-administration-has-approved-48-trillion-new-borrowing">analysis</a> from the Committee for a Responsible Federal Budget.”
Despite Manchin’s posturing on the national debt, in late July he agreed to vote for the Inflation Reduction Act of 2022, claiming it would “address record inflation by paying down our national debt.”
“It is past time for America to begin paying down our $30 trillion national debt and get serious about the record inflation that is crushing the wages of American workers,” Manchin <a href="https://www.manchin.senate.gov/newsroom/press-releases/manchin-supports-inflation-reduction-act-of-2022" target="_blank" rel="noopener">declared</a>.
He praised the Democratic leadership in Washington, stating, “President Biden, Leader Schumer and Speaker Pelosi have committed to advancing a suite of commonsense permitting reforms this fall that will ensure all energy infrastructure, from transmission to pipelines and export facilities, can be efficiently and responsibly built to deliver energy safely around the country and to our allies.”
He concluded, “I support the Inflation Reduction Act of 2022 because it provides a responsible path forward that is laser focused on solving our nation’s major economic, energy and climate problems. The question for my colleagues is whether they are willing to put their election politics aside and embrace the commonsense approach that the overwhelming majority of the American people support and will best serve the future of this nation.”
The Inflation Reduction Act was criticized by some; a UPenn-Wharton assessment <a style="font-style: inherit; font-weight: inherit;" href="https://budgetmodel.wharton.upenn.edu/issues/2022/7/29/inflation-reduction-act-preliminary-estimates" target="_blank" rel="noopener" data-testid="standard-link">stated</a> it would “very slightly increase inflation until 2024 and decrease inflation thereafter” at a rate “statistically indistinguishable from zero.” The assessment also concluded that the final version <a style="font-style: inherit; font-weight: inherit;" href="https://budgetmodel.wharton.upenn.edu/issues/2022/8/12/senate-passed-inflation-reduction-act" target="_blank" rel="noopener" data-testid="standard-link">would</a> “slightly reduce GDP in the first decade while slightly increasing GDP by 2050.”

Joe Manchin

Manchin Differs With Sanders About Debt Limit, Acknowledges ‘Crippling Debt’

Economy

National Debt

Social Security

People who identify as &#8220;non-binary&#8221; are undergoing bizarre, taxpayer-funded surgeries that render them &#8220;smoothies,&#8221; where the genitals are completely removed, leaving the area looking like the crotch of a Ken or Barbie doll.
The surgery, known in medical circles as &#8220;nulloplasty,&#8221; is among a new wave of alternatives to more “traditional” <a href="https://www.dailywire.com/topic/transgender" target="_blank" rel="noopener">transgender</a>-related genital surgeries such as phalloplasty and vaginoplasty. They also include surgery to give the patient the appearance of both sex organs, as with a hermaphrodite, and some of the new operations are covered by taxpayer-funded insurance plans, The Daily Wire found.
“We understand that some patients will not be looking specifically for binary surgeries,&#8221; reads the MoZaic Care <a href="https://www.mozaiccare.net/gender-nonconforming" target="_blank" rel="noopener">website</a>, a surgery center in San Francisco that specializes in genital surgeries for transgender and “nonbinary” patients. &#8220;For gender diverse, expansive, nonbinary patients; we offer individualized surgical options. Examples include penile preservation vaginoplasty, vaginal preservation with metoidioplasty and nullification.&#8221;
Recipients of the surgery refer to themselves as &#8220;smoothies,&#8221; &#8220;Ken dolls&#8221; or &#8220;nullos.&#8221;
“Nonbinary” is a popular identity under the transgender “umbrella” for individuals who reject both masculine and feminine stereotypes and social roles. Over one million adults in the U.S. identify as “nonbinary,” according to a 2021 <a href="https://williamsinstitute.law.ucla.edu/publications/nonbinary-lgbtq-adults-us/" target="_blank" rel="noopener">UCLA survey</a>. As the transgender umbrella expands to include the ever-growing list of gender identities — such as demiboy, eunuch, gendervoid, maverique, neutrois, etc. — plastic surgery centers are offering customizable surgeries that cater to them.
Nullification surgery “removes external genitalia while preserving a urethral opening and anal opening,” according to the MoZaic Care <a href="https://www.mozaiccare.net/nullification" target="_blank" rel="noopener">website</a>. While nullification is most often marketed to males, MoZaic offers it to both sexes. 
“If the patient was born with a penis, the penis will be removed in addition to both testicles and the scrotum,” reads MoZaic’s website.​ “If the patient was born with a vagina, the vagina will be removed in addition to the clitoris and labia.” Recipients of nullification surgery sometimes refer to themselves as a &#8220;nullo&#8221; or &#8220;<a href="https://en.wikipedia.org/wiki/Nullo_(body_modification)" target="_blank" rel="noopener">smoothie</a>&#8221; to denote the &#8220;smoothness&#8221; of their genital area after the procedure.
“Basically for the nullification surgery, they remove the testicles, the scrotum, and the penis, and they essentially just sew the skin up into a very tight vertical line which kind of fades away,&#8221; one man who received a nullification surgery <a href="https://www.queerty.com/nullo-man-felt-masculine-better-sex-getting-penis-removed-20181229" target="_blank" rel="noopener">explained</a>. &#8220;If the surgeon’s great, there’s no scar at the end of it, and they relocate the urethra down to kind of between your legs.”
Penile preservation vaginoplasty — offered to males — and vaginal preservation with metoidioplasty — offered to females — are custom surgeries that allow the individual to obtain the &#8220;hermaphrodite look&#8221; and have the appearance of both male and female genitalia at the same time. Penile preservation vaginoplasty, or as MoZaic calls it, a “<a href="https://www.mozaiccare.net/peritoneal-pull-through-vaginoplast" target="_blank" rel="noopener">Phalgina</a>,” differs from a more traditional vaginoplasty as it does not involve a penectomy (surgical removal of the penis) and uses the genital tissue from the scrotum via orchiectomy (removal of the testes) to create a pseudovagina.
More “traditional” transgender surgeries are also offered, including <a href="https://www.mozaiccare.net/hysterectomy-faqx" target="_blank" rel="noopener">hysterectomies</a> and <a href="https://www.mozaiccare.net/vaginoplasty-faqs" target="_blank" rel="noopener">vaginoplasties</a> that are available for minors as young as 15, as long as they are emancipated or “live apart from [their] parents or guardians, and manage [their] own financial affairs.”
According to the MoZaic website, federally funded insurance plans require a minimum age of 21 to receive sterilizing genital surgeries.
 “Federally funded (have Medi-cal or Medicaid) patients, must be 21 years of age to undergo elective sterilization surgery,” the site&#8217;s pages for <a href="https://www.mozaiccare.net/vaginoplasty-faqs" target="_blank" rel="noopener">vaginoplasty</a> and <a href="https://www.mozaiccare.net/hysterectomy-faqx" target="_blank" rel="noopener">hysterectomy</a> FAQs read. Eighteen-year-olds can obtain sterilizing genital surgeries if done through private insurance or paid for out-of-pocket.
San Francisco Health Plan, a form of Medi-Cal, and Blue Cross Covered California, another state-sponsored insurance, are a few of the accepted insurance options at MoZaic. California law prohibits insurance companies from denying medical insurance benefits for transgender-related care. In 2021, $13 million was allocated to the <a href="https://www.translatinacoalition.org/press/2021/8/3/historic-funding-of-13-million-dollars-to-the-transgender-wellness-and-equity-fund-by-governor-newsom-announced" target="_blank" rel="noopener">Transgender Wellness and Equity Fund</a> in the state budget that California Governor Gavin Newsom signed off on to fund these services. While prior authorization from a physician is required, transgender and “gender diverse” patients are rarely denied and many <a href="https://transequality.org/know-your-rights/medicare" target="_blank" rel="noopener">advocacy groups</a> assist people in appeals to any Medicare denials.
Dr. Heidi Wittenberg, the director of MoZaic, boasts about having  performed hundreds of genital surgeries. Dr. Adam Bonnington is another surgeon at MoZaic who celebrated his 100th vaginoplasty in April of this year.
<div id="attachment_438497" style="width: 722px" class="wp-caption aligncenter"><img aria-describedby="caption-attachment-438497" decoding="async" loading="lazy" class="wp-image-438497 " src="https://www.dailywire.com/wp-content/uploads/2022/09/photo-output.jpg" alt="" width="712" height="535" srcset="https://dw-wp-production.imgix.net/2022/09/photo-output.jpg 2048w, https://dw-wp-production.imgix.net/2022/09/photo-output-300x225.jpg 300w, https://dw-wp-production.imgix.net/2022/09/photo-output-767x576.jpg 767w, https://dw-wp-production.imgix.net/2022/09/photo-output-768x577.jpg 768w, https://dw-wp-production.imgix.net/2022/09/photo-output-1536x1154.jpg 1536w" sizes="(max-width: 712px) 100vw, 712px" />Screenshots from the @mozaic_care Instagram account</div>
Wittenberg is also the medical director of The Gender Institute at Saint Francis Memorial Hospital (SFMH), where “Gender Expansive/Non-binary Procedures” that include nullification surgery, penile preserving vaginoplasty, and vaginal preserving metoidioplasty are also <a href="https://www.dignityhealth.org/bayarea/locations/saintfrancis/services/gender-institute/services-and-providers" target="_blank" rel="noopener">offered</a>. SFMH, through Dignity Health, accepts <a href="https://www.dignityhealth.org/bayarea/locations/saintfrancis/patients-and-visitors/for-patients/insurance-plans-accepted" target="_blank" rel="noopener">various forms</a> of state-sponsored health care plans and assists patients in linking them with federal funding to foot their genital surgery bill.
 “If you need help paying your bill, you may qualify for a government-sponsored program or Dignity Health Payment Assistance Program that may cover some or all of your balance,” according to Dignity Health’s <a href="https://www.dignityhealth.org/my-care/billing-help-and-faq" target="_blank" rel="noopener">Billing Help and FAQs</a>.
Surveys report that around one in four transgender and “nonbinary” people choose “gender affirmation” surgery, according to the <a href="https://my.clevelandclinic.org/health/treatments/21526-gender-affirmation-confirmation-or-sex-reassignment-surgery" target="_blank" rel="noopener">Cleveland Clinic</a>. According to a 2019 <a href="https://www.liebertpub.com/doi/10.1089/lgbt.2018.0175" target="_blank" rel="noopener">study</a>, the rate of patients using Medicare to facilitate their transition has experienced a meteoric rise.
 “Within the Medicare program, the number of beneficiaries identified as transgender through claims data in each year has increased from 2088 beneficiaries in 2010 to 10,242 beneficiaries in 2016 (a 390% increase),” the study found.
Another <a href="https://pubmed.ncbi.nlm.nih.gov/33422448/" target="_blank" rel="noopener">recent study</a> found that 34 of 51 (67%) states&#8217; Medicaid programs include GAHT (gender-affirming hormone therapy) and 25 of 51 (49%) include GAS (gender affirming surgeries) as covered benefits.
MoZaic Care explicitly states on their website they follow WPATH guidelines. The World Professional Association for Transgender Health (WPATH) recently <a href="https://www.dailywire.com/news/leading-transgender-health-association-releases-new-guidelines" target="_blank" rel="noopener">published</a> its updated Standards of Care 8th Edition, which now includes “Eunuchs” as a gender identity. WPATH recommends medical treatment and services for those who self-identify as a “Eunuch,” who are typically <a href="https://reduxx.info/top-trans-medical-association-collaborated-with-castration-child-abuse-fetishists/" target="_blank" rel="noopener">men with castration fetishes</a> seeking nullification surgery to remove their genitals. Wittenberg spoke at the 27th annual WPATH conference that occurred September 16-20, 2022.
<a href="https://www.poststreetsurgery.com/gender-affirmation/non-binary/" target="_blank" rel="noopener">Post Street Surgery Center</a> and <a href="https://www.mymarinhealth.org/programs-services/surgery-procedures/surgical-specialties/gender-affirmation-surgery/nonbinary-gender-affirming-surgery/" target="_blank" rel="noopener">Marin Health</a> are two other California-based clinics who offer “nonbinary gender affirming surgery” and accept <a href="https://www.mymarinhealth.org/patients-visitors/medical-network-patients/accepted-healthcare-plans/" target="_blank" rel="noopener">state-sponsored insurance</a>. While <a href="https://www.alignsurgical.com/non-binary/" target="_blank" rel="noopener">Align Surgical Associates</a> in San Francisco does not accept Medicaid, Medicare, or Medi-cal as a form of financing, private insurance covers “non-standard gender affirming surgery.” Dr. Dev Gurjala of Align Surgical thinks of himself as a “designer” of custom genital surgeries.
<a href="https://www.ohiohealth.com/health-and-wellness/lgbtq-healthcare" target="_blank" rel="noopener">Ohio Health Hospital</a> and <a href="https://www.cmreconstructiveurology.com/specialties/transgender-gender-affirmation-care/" target="_blank" rel="noopener">Dr. Chris McClung</a> in Ohio offer nullification surgery to transgender patients and accept various forms of Medicaid as <a href="https://www.ohiohealth.com/patients-and-visitors/paying-for-your-care/accepted-insurance/central-ohio-hospitals-accepted-insurance" target="_blank" rel="noopener">insurance</a>. Ohio State Medicaid policy excludes transgender health coverage and care, but multiple news outlets including The Washington Post and Bloomberg News report that state officials since 2019 have <a href="https://www.lgbtmap.org/img/maps/citations-medicaid.pdf" target="_blank" rel="noopener">not been enforcing this exclusion</a>.

Barbie Doll Ken (Mattel) toy made of polyethylene seen at

Taxpayers Are Funding Clinics That Perform Unnatural Surgeries On ‘Nonbinary’ Patients

Bizarre New Genital Surgery For 'Non-Binaries' Gives 'Smoothies' Ken Doll Look

LGBTQ

Readers Pass

San Francisco

Forget Medicaid expansion. Congress is pushing a Medicaid takeover.
That’s the unspoken reality of Democrats’ $3.5 trillion spending bill, a major part of which concerns the federal low-income health care program. While the bill is being sold as a means of providing coverage to millions more people, it would fundamentally change a big part of Medicaid from a state-run model to a purely federal operation. Such a shift would leave the already struggling program even less able to meet the medical needs of vulnerable Americans.
The impetus behind this transformation is simple. President Biden and congressional Democrats dislike that <a href="https://www.macpac.gov/subtopic/medicaid-expansion/">12 states</a> have refused to expand Medicaid under Obamacare. From Texas to Florida to South Dakota, governors and state legislators have held out for the better part of a decade. Years of pressure have failed to convince these states to give in, so the president and Congress have decided to force it on them anyway.
Their state opposition is grounded in common sense. Costly Medicaid expansion <a href="https://thefga.org/wp-content/uploads/2019/10/Medicaid-Pac-Man-Paper-2.pdf">crowds out state spending on education, infrastructure, and other key priorities</a>, making it harder for officials to meet the needs of their citizens. Expansion also <a href="https://thefga.org/press/new-fga-research-shows-how-medicaid-expansion-would-crowd-out-private-insurance/">shifts people</a> from higher-quality private insurance to a lower-grade, government-run plan, leaving them with worse access to care and health outcomes. Finally, Medicaid expansion <a href="https://thefga.org/solution/medicaid/medicaid-expansion/">opens the program to a new class of able-bodied adults</a>, who Medicaid was never meant to cover. That makes it harder for states to help the truly needy, which is the entire point of Medicaid.
Democrats ignore these realities in the $3.5 trillion spending bill, making no attempt to reform Medicaid’s well-known challenges. Instead, they want to create a new federally run Medicaid program that bypasses the 12 hold-out states and nationalizes Obamacare’s Medicaid expansion. Currently, Medicaid is operated by state governments, though it is <a href="https://www.macpac.gov/wp-content/uploads/2015/01/EXHIBIT-16.-Medicaid-Spending-by-State-Category-and-Source-of-Funds-FY-2020-millions.pdf">mostly paid for by federal tax</a>payers. The new program would be 100 percent controlled by Washington, D.C. – and that’s a problem.
The 38 states that have already expanded Medicaid would want to ditch the old expansion in favor of the new one. They’re currently paying 10 percent of expansion’s total costs and as much as 50 percent of Medicaid’s administrative costs, but under a federally run program, D.C. could cover all of the latter and potentially all of the former. States could shift hundreds of millions or even billions of dollars to federal taxpayers, depending on the state. While any legislation is likely to bar states from dropping Medicaid expansion, <a href="https://www.wsj.com/articles/affordable-care-act-obamacare-medicaid-expansion-insurance-health-care-reconciliation-11632259356">some experts believe such a provision would be unenforceable</a>. In fewer than four years, all 50 states and D.C. could offload their expansion populations to the federal government.
But they wouldn’t just be sticking federal taxpayers with the bill. They’d be sticking federal regulators with the bureaucratic details – everything from cost to access to the requirements that Medicaid recipients must meet. The program is already known to force one-size-fits-all mandates on states, and the last thing it needs is more of the same. Medicaid’s struggles would only grow worse, because federal officials are uniquely unsuited to address the health care needs of such a diverse country.
Congressional Democrats should ask if they really want to empower the federal government instead of protecting their states. Does Senator Sinema, who has previously opposed federal policies affecting Arizona’s Medicaid program, really want to give D.C. more control over her state? Does Senator Joe Manchin really want to make it harder for West Virginia to do things like its <a href="https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/83561">current Medicaid experiment to treat substance abuse disorder</a>?
Federally run Medicaid is the last thing the ailing program needs. Instead, Congress should look for ways to give states more freedom and flexibility, the better to serve their most vulnerable citizens. Medicaid expansion has already made that mission harder to fulfill. A Medicaid takeover would make it all but impossible.
The views expressed in this opinion piece are the author’s own and do not necessarily represent those of The Daily Wire.
Jonathan Ingram is vice president of policy and research at the Foundation for Government Accountability.

Health care

Forget Medicaid Expansion. Congress Is Pushing A Medicaid Takeover.

Democratic Party

We are still more than a year away from the Democratic National Convention in Milwaukee, Wisconsin, but no matter who is officially named as President Donald Trump’s opponent, we already know he or she will be pushing for a government takeover of the health care sector.
The only question is how fast.
All of the top U.S. senator candidates, including Sens. Cory Booker (D-NJ), Kamala Harris (D-CA), and Elizabeth Warren (D-MA), have endorsed Sen. Bernie Sanders’s (I-VT) “Medicare For All” health care bill. This is the most direct route to government-run medicine.
But while former Vice President Joe Biden and South Bend, Indiana Mayor Pete Buttigieg have, so far, declined to sign on to Sanders legislation, they both have endorsed “single-payer lite” alternatives that purportedly let Americans “buy-in” to Medicare.
Unfortunately, as Juniper Research Group CEO Chris Jacobs explains in his <a href="https://www.amazon.com/Case-Against-Single-Payer-System_And/dp/1645720020">new book, “The Case Against Single Payer,”</a> all of these Medicare buy-in plans are simply slightly slower ways to get to the desired single-payer goal.
The problem with all of these plans, from both “Medicare For All to “Medicare For All Who Want It,” is that they are all pegged to the Medicare reimbursement system.
The thing is, doctors and hospitals do not get paid the same amount for every patient they see. Each private insurer negotiates a rate with hospitals, and then the government sets the rates for Medicare and Medicaid patients.
And hospitals get paid far less for the Medicare and Medicaid patients they serve. Currently, Medicare pays hospitals just 60% of what private insurance pays and Medicaid pays just 61%. If hospitals could only charge the Medicare reimbursement rate, many of them would go out of business. According to the Centers for Medicare and Medicaid Services, 72% of hospitals lost money on their Medicare patients in 2017.
So, if most hospitals are losing money on every Medicare patient they serve, then where are they making all their money? From private insurance. And this is why the Medicare “buy-in” plans are no better than the “Medicare For All” plans.
The more people “buy-in” to Medicare, the more Medicare patients hospitals serve, and the more hospitals have to recuperate that money by charging private insurance more. The more insurers have to pay hospitals, the higher insurance premiums go, causing more and more people to “buy-in” to Medicare.
“Medicare For All Who Want It” plans are really just a death spiral for private insurance that will eventually lead to “Medicare For All Whether They Want It Or Not.”
“Good!” single-payer advocates will say. The sooner private insurance dies the better! “The insurance companies last year alone sucked $23 billion in profits out of the health care system, $23 billion,” Sen. Warren said at the first Democratic debate.
But as Jacobs notes in his book, when you start to look at all the fraud and abuse in the Medicare and Medicaid systems, that $23 billion in insurance profits starts to look like a bargain. In 2018 alone, Medicare ($48.5 billion) and Medicaid ($36.2 billion) made $84.7 billion in fraudulent and improper payments. Not a dime of that money made a single patient healthier. It was a pure loss for taxpayers.
And that number would only skyrocket if Medicare became the only way Americans were allowed to finance health care. “In 2018,” Jacobs writes, “Americans spent nearly $3.65 trillion on health care. If a single-payer system in control of all that health spending maintains an improper payment rate equal to the current fee-for-service Medicare program, that would imply approximately $296.1 billion in spending on fraudulent or improper payments every year.”
There are many more reasons Americans should reject single-payer health care, and Jacobs touches on many of them in his book, including: Doctors being forced to perform abortions, the doubling all personal and corporate income taxes, and the loss of 1.5 million hospital jobs.
Our current system definitely has its flaws, and Jacobs has some suggestions on how to make it better; but the last thing we should do is double down on the worst parts of our existing system. Single-payer health care, however, would do just that.
Mike Lee, a Republican, is the senior U.S. senator from Utah.

LEE: Everything You Need To Know To Fight Single-Payer

Democratic Socialism

Medicare

Socialism

&#8220;There are two ways to conquer and enslave a nation. One is by the sword and the other is by debt.&#8221;
&#8211; John Adams

Paul Ryan, for all his flaws as an immigration dove and record of taking tough votes such as the grotesquely cronyist <a href="https://www.politico.com/story/2012/08/ryans-voting-record-big-spending-conservatism-079688">TARP bailout</a>, was nonetheless almost single-handedly responsible for making entitlement reform a part of Republican Party economic orthodoxy. Ryan&#8217;s &#8220;<a href="https://paulryan.house.gov/news/documentsingle.aspx?DocumentID=201669">Roadmap for America&#8217;s Future</a>,&#8221; first introduced in 2008 and <a href="https://www.cbo.gov/publication/41860">later</a> more fully flushed out, detailed the Wisconsin congressman&#8217;s policy vision for a future that included structural reforms &#8212; including means-testing, introduction of competitive market forces, and optionality for privatization measures &#8212; to America&#8217;s bankrupting entitlement programs of Medicare, Medicaid, and Social Security. In the era of Barack Obama&#8217;s trillion-dollar deficits and quasi-nationalization of the health insurance industry, Ryan&#8217;s arguments quickly moved from the wonky fringe to the mainstream of GOP policy advocacy. The culmination of Ryan&#8217;s popularity within the party was his being tapped as Mitt Romney&#8217;s running mate in the 2012 presidential election.
The nomination and subsequent election of Donald Trump severely shifted the mood, within the GOP, as to the desire for and urgency of entitlement reform measures. Trump, famously, campaigned on populist pleas to &#8220;protect&#8221; Medicare and Social Security against those who would seek to structurally reform the programs so as to make them fiscally sustainable. Seen through this prism, Trump&#8217;s shifting the GOP away from entitlement reform may be viewed as part of the broader <a href="https://www.dailywire.com/news/42234/hammer-path-forward-conservative-movement-josh-hammer">tension</a> within conservative ranks between traditional libertarian/neoliberal laissez-faire and ascendant Tucker Carlson economic populism.
The GOP can, and should, air out policy debates that may sometimes offend the delicate sensibilities of The Wall Street Journal editorial board and other bastions of 1980s-style Reaganism. A debate over low-skilled legal immigration &#8212; or legal immigration levels, more generally &#8212; cannot be an untouchable third rail. And more generally, it is entirely appropriate for Republicans to debate among themselves whether it makes more sense for a macroeconomy to more highly value gross domestic product and economic growth or to more highly value, à la <a href="https://www.amazon.com/Once-Future-Worker-Renewal-America-ebook/dp/B079617VFZ">Oren Cass</a>, the inherent dignity of labor.
It is quite likely that Trump&#8217;s reflexive opposition to entitlement reform measures amounts to a symptom &#8212; and not a cause &#8212; of the pulse of the Republican voting base. Giving away Free Stuff&#8482;&#65039; has always had strong bipartisan appeal. Sober, hard-headed straight talk about the absolute necessity to cut bankrupting spending programs? Not so much.
But Republicans need to rise to the occasion. There are two simple reasons. First, the impending <a href="https://www.wsj.com/articles/the-debt-crisis-is-coming-soon-11553122139">debt crisis</a> is very, very real absent structural entitlement reform. Second, the Republican Party &#8212; warts and all &#8212; remains the only political vessel that stands any (modicum) chance of advocating an intellectually serious approach to national fiscal solvency.
A Wall Street Journal <a href="https://www.wsj.com/articles/the-debt-crisis-is-coming-soon-11553122139">op-ed</a> last week by Harvard professor and longtime conservative economist Martin Feldstein succinctly lays out the problem:
<blockquote>
According to the Congressional Budget Office, the deficit this year will be $900 billion, more than 4% of gross domestic product. It will surpass $1 trillion in 2022. The federal debt is now 78% of GDP. By 2028, it is projected to be nearly 100% of GDP and still rising. All this will have very serious economic consequences, and the CBO understates the problem. It has to base its projections on current law&#8212;in this case, the levels of spending and the future tax rules and rates that appear in law today. 
Those levels don&#8217;t match realistic predictions. Current law projects that defense spending will decline as a share of GDP, from a very low 3.1% now to about 2.5% over the next 10 years. None of the military and civilian defense experts with whom I&#8217;ve spoken believe that will happen, given America&#8217;s global responsibilities and the need to modernize U.S. military equipment. It is likelier that defense spending will stay around 3% of GDP or even increase in the coming decade. And if the outlook for defense spending is increased, the Democratic House majority will insist that the nondefense discretionary spending should rise to match its trajectory. &#8230;
What does that mean for the long-run ratio of the federal debt to GDP? Federal debt will probably surpass 100% much sooner than 2028. If discretionary spending increases, debt growth will jump to 100% even quicker. When America&#8217;s creditors at home and abroad realize this, they will push up the interest rate the U.S. government pays on its debt. That will mean still more growth in debt. &#8230;
To avoid economic distress, the government either has to impose higher taxes or reduce future spending. Since raising taxes weakens incentives and further slows economic growth&#8212;worsening the debt-to-GDP ratio&#8212;the better approach is to slow government spending growth. &#8230; 
Thus the only option is to throw the brakes on entitlements. In particular, the government needs to hold back the growth of Medicare, Medicaid and Social Security. Federal spending on the two major health programs is projected to rise from its current 5.5% of GDP to more than 7.2% by 2029. And it will only keep increasing after that.
</blockquote>
Or consider the prolific Brian Riedl, <a href="https://economics21.org/html/yes-entitlements-are-driving-long-term-debt-3025.html">writing</a> last April at Manhattan Institute&#8217;s &#8220;Economics 21&#8221; blog. Riedl lays out the staggering numbers pertaining to our bankrupting entitlement programs&#8217; impending fiscal shortfalls.
<blockquote>
CBO&#8217;s Long-Term Budget Outlook shows that between 2017 and 2047, Social Security and Medicare will run a cash deficit of $82 trillion. Specifically, Medicare will run a $40 trillion cash deficit, Social Security will run a $19 trillion cash deficit, and the interest costs of those deficits will add $23 trillion more. The rest of the budget had been projected to run a $4 trillion surplus over this period, although making the latest tax cuts permanent would likely change this to a roughly $5 trillion deficit.
As a percentage of GDP, CBO projects that Social Security and Medicare will continue to collect approximately 6 percent of GDP in dedicated revenues yet see spending rise from 8.1 percent today to 12.5 percent of GDP by 2047 &#8211; or 16.4 percent when including the interest cost of these deficits. The rest of the budget will remain approximately balanced at around 12 percent of GDP (or run a 1 percent deficit if the tax cuts are extended).
Generally, federal program spending outside Social Security, Medicare, and Medicaid is projected to continue declining as a share of the economy. Tax revenues &#8211; even with the tax cuts made permanent &#8211; are expected to soar past the 17.4 percent of GDP average of the past few decades and then continue rising due to inflationary increases in taxes and taxed retirement distributions.
In other words, CBO projects above-average tax revenues and falling spending for other programs. But the rise in Social Security, Medicare, and resulting interest costs from 8.1 percent to 16.4 percent of GDP between 2017 and 2047 determines nearly the entire rise in budget deficits.
</blockquote>
Perhaps, as investor Todd Stein <a href="https://www.foxbusiness.com/economy/the-federal-government-should-default-on-its-debt">argues</a> at Fox Business, the current situation with our debt is already so hopeless that policymakers ought to consider a &#8220;soft default&#8221; &#8212; what Stein describes as a &#8220;one-time devaluation of the dollar which enables the government to pay back its debts in full, albeit at a lower intrinsic value.&#8221; Suffice it to say this is not a particularly pleasant thought experiment. Credit markets in economically lesser countries, such as Argentina, have often historically rebounded from sundry sovereign defaults. But how that situation would unfold in the context of the United States, the wealthiest nation in the world whose dollar serves as the world&#8217;s reserve currency, is at best an unsure proposition.
Perhaps a &#8220;soft default&#8221; will one day become necessary. Indeed, perhaps that day is sooner rather than later. 
But we are not quite there yet.
The better solution, in the immediate term, is for the Republican Party to make an actual public commitment to structural reform of our bankrupting entitlement programs. The GOP is the only major political party in America right now that has any chance of staving off a Greece/Italy-style debt crisis, wherein debt and interest rates begin to simultaneously rise in unsustainable seesaw fashion. It is only the GOP that has any fidelity &#8212; no matter how vestigial it may seem, at times &#8212; to free-market economics and the notion that private investment, which necessarily depends on not being <a href="https://www.investopedia.com/terms/c/crowdingouteffect.asp">crowded out</a> by debt-inducing government largesse, is the best economic engine for mass societal prosperity.
It is only the Republican Party that is capable of discussing our bankrupting entitlement program crisis like mature adults. Republicans should rise to the occasion. The future solvency of the republic depends on it.

HAMMER: Republicans Need To Be Adults And Talk About Entitlement Reform Again

Conservatism

Donald Trump

Entitlement Reform

Republican Party

A California Democrat is promising he will reintroduce a bill that would give Medicaid coverage to illegal immigrants over the age of 19. State Assembly member Dr. Joaquin Arambula from Fresno made his announcement on Monday, according to <a href="https://www.latimes.com/politics/la-pol-ca-california-legislature-convenes-20181203-story.html">The Los Angeles Times.</a>
If Arambula gets his way with Assembly Bill 4, the full benefits of the California Medical Assistance Program (Medi-Cal) would be available for all low-income earners, even if they are illegal immigrants. Under current law, all children in California, whether illegal immigrants or not, have access to Medi-Cal benefits including hospitalization, prescription drugs, oral, and vision care. According to a <a href="https://sbud.senate.ca.gov/sites/sbud.senate.ca.gov/files/SUB3/03222018Sub3Health.pdf">Senate Bill Policy Committee analysis</a>, by the end of 2017, 218,571 children who were illegal immigrants had enrolled in full-scope Medi-Cal.
California would be the first state to pass such legislation. As <a href="https://www.washingtonexaminer.com/policy/healthcare/california-democrats-plan-to-extend-medicaid-to-illegal-immigrants">The Washington Examiner</a> notes, &#8220;State projections for last year&#8217;s bill found that 1.8 million people in California are uninsured and reside there illegally; roughly 1.2 million would qualify for Medi-Cal, the name of the state&#8217;s Medicaid program.&#8221;
Last April, <a href="https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201720180SB974">Senate Bill 974</a>, introduced by state Sen. Ricardo Lara passed the Senate health committee. It stated, &#8220;An individual who is under 19 years of age, or 65 years of age and older, and who does not have satisfactory immigration status or is unable to establish satisfactory immigration status, as required by Section 14011.2, shall be eligible for the full scope of Medi-Cal benefits, if he or she is otherwise eligible for benefits under this chapter.&#8221;
Shortly afterward, Arambula&#8217;s <a href="v">Assembly Bill 2965</a> was passed by the State Assembly&#8217;s health committee. It <a href="https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201720180AB2965">stated</a>, &#8220;This bill would extend eligibility for full-scope Medi-Cal benefits to individuals who are under 26 years of age and who are otherwise eligible for those benefits but for their immigration status.&#8221;
Neither of those bills made it into law, as Gov. Jerry Brown refused to fund them. Both of the earlier bills covered young adults between the ages of 19 and 26 and immigrants over the age of 65. The new bill is estimated to cost $3 billion a year, according to California&#8217;s Legislative Analyst&#8217;s Office.
Incoming Gov. Gavin Newsom is expected to support efforts to offer Medi-Cal to illegal immigrants. He <a href="https://thehill.com/homenews/state-watch/404036-dem-calif-gov-candidate-government-should-give-undocumented-immigrants">said</a> in August, &#8220;I did universal healthcare when I was mayor &#8212; fully implemented, regardless of pre-existing condition, ability to pay, and regardless of your immigration status &#8230; I&#8217;d like to see that extended to the rest of the state &#8230; San Francisco is the only universal healthcare plan for all undocumented residents in America. Very proud of that. And we proved it can be done without bankrupting the city &#8230; The executive needs to lead it. ObamaCare would not have happened if it was just exclusively a legislative fiat. That said, <a href="https://thehill.com/people/nancy-pelosi">Nancy Pelosi</a> did a magical job of organizing it, but it required the concerted efforts of the president of the United States.&#8221;
Carolina Gamero, a spokeswoman for the California Immigrant Policy Center, <a href="https://endigest.com/2018/12/04/more-undocumented-immigrants-in-california-would-get-health-care-under-democrats-plan/">stated,</a> &#8220;It&#8217;s something that is urgently needed across immigrant communities in California. The longer that we wait and the longer we keep up this unjust exclusion, it&#8217;s really setting back California.&#8221;
Rachel Linn Gish, spokeswoman for consumer group Health Access California, echoed, &#8220;You cannot talk about universal health care in California unless you talk about health care for the undocumented.&#8221;

CA Dems Pushing For Medicaid For Illegal Immigrants

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