Vice President JD Vance needs to prioritize one policy change above all others as he leads the Trump administration’s crackdown on fraud in California and elsehwere: closing a loophole that is allowing thousands of illegal aliens to receive Medicaid.
Federal law requires states to verify the citizenship or immigration status of people who apply for Medicaid (which is Medi-Cal in California), but gives them a “reasonable opportunity period” to provide documentation.
The minimum grace period is 90 days, under federal regulations. a long grace period. But bureaucrats have stretched it into permanent enrollment, funneling our tax dollars to illegal aliens who shouldn’t even be in the country.
Nathan Posner/Shutterstock States add to the problem by granting new “reasonable opportunity periods” to the same people over and over again, keeping illegal aliens on Medicaid indefinitely.
For example, one Utah Medicaid applicant has been enrolled for 5,820 days without proving their immigration status. That is 16 years of welfare without proof of eligibility.
Think back to where you were 16 years ago. The iPad didn’t exist, Blockbuster Video still had thousands of stores, and three in four Americans still had a landline.
That enrollee has been drawing Medicaid benefits every single day since, while state officials wait for proof of citizenship that has never come.
But Utah is not even an outlier. Seven in 10 “temporary” Medicaid cases now exceed 90 days, and the federal government allows it.
What’s more, Governor Gavin Newsom’s California may be the worst offender of all, but his administration doesn’t want you to know it.
When my organization filed a public records request to find out how many people are exploiting these extensions, the California Department of Health Care Services strung us along for four months, with delay after delay, before it demanded $182,000 to produce the data.
Apparently, the Newsom administration needs its own “reasonable opportunity period” when it comes to transparency.
In total, an estimated 700,000 people receive these “reasonable opportunity periods” each year, a population larger than Washington, D.C., costing taxpayers millions of dollars.
The Medicaid program is on track to lose $2 trillion to waste, fraud, and abuse over the next decade. More than one in five dollars spent on the program is improper, and eligibility errors drive more than 80 percent of that.
Taxpayers are spending billions of dollars every year on people who were never eligible in the first place, or who stayed enrolled long after their circumstances changed.
During the Biden border crisis, the number of applicants who couldn’t prove their immigration status exploded nearly five-fold, as more illegal aliens came flooding in and states kept extending benefits to people with no legal right to them.
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The Biden administration even formalized this blatant abuse, requiring states to keep granting grace periods to the same applicants.
Although President Trump has solved the border crisis, the problem of illegal aliens receiving welfare is far from solved. In fact, now these outrageous welfare abuses could even get worse.
Left-wing groups are lobbying states to adopt “One Door” eligibility systems, which some states already use to enroll applicants in every welfare program at once if they apply for any of them.
These systems are designed to maximize enrollment, even if it means more fraud and abuse by those who aren’t even eligible for benefits.
After a certain point, reasonable opportunity periods aren’t so reasonable. The Trump administration should limit a reasonable opportunity period to 30 days, which is more than enough time for law-abiding people to track down missing paperwork.
Additionally, states should limit each applicant to one reasonable opportunity period instead of opening new ones over and over again for the same people.
States also need to hold illegal aliens accountable if they try to get tax dollars for which they are not eligible. If an applicant’s verification fails, states should share this information be with immigration enforcement, as Louisiana and Indiana already do. Not only are these applicants here illegally, but they are also attempting to steal from taxpayers.
Ultimately, Congress should change the law and require pre-enrollment verification. It should end the reasonable opportunity period loophole entirely. Congress should also require states to follow Louisiana and Indiana’s lead in referring illegal aliens to immigration authorities when they try to steal welfare.
The Vice President’s anti-fraud task force has a tall task ahead of it, but there are few easier steps to take than this one. Sixteen years of waste, fraud, and abuse of our tax dollars is enough.
It is time to close this loophole once and for all.
Jonathan Ingram is vice president of policy and research at the Foundation for Government Accountability.
