Congress Could Fix The Entitlement Fraud Problem Overnight But Won’t

The current major problems of federal budget pressures and health care affordability for all consumers require action.

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The real tragedy behind the Minnesota welfare scandal is an underclass trapped in poverty by 'anti-poverty' programs.

Democrats Who Let Covid-Era Child Tax Credits Expire Now Cry ‘Crisis’ Over Lapsing Obamacare Giveaway

Why is it only a 'crisis' when a spending program expires on Republicans’ watch?

The Obamacare subsidy fight exposes who Washington really serves



The failure of both Democrat and Republican plans to extend or partially replace enhanced Obamacare subsidies offers a clear lesson: Escaping an entitlement trap almost never happens.

Yes, the House of Representatives on Thursday voted to extend the COVID-era Affordable Care Act subsidies that expired at the end of 2025. Seventeen Republicans even joined a unanimous Democratic Caucus in voting for the extension. But Senate Majority Leader John Thune (R-S.D.) said Republicans have “no appetite” for an extension — at least not without reforms.

Republicans remain an impediment to the necessary reforms and are working hand in hand with Democrats to bring on economic collapse. Time is not on our side.

The reality is, once government creates a welfare entitlement, logic and sustainability exit the conversation. Politicians do not debate whether to grow the program. They argue only over how much to increase spending and how to disguise the costs. That pattern now governs the fight over enhanced Obamacare subsidies.

Why the premise never gets challenged

When the Senate rejected a nearly identical bill in December, the Wall Street Journal reported that Congress faces “no clear path for aiding millions of Americans facing soaring Affordable Care Act insurance costs next year.”

The Journal’s framing accepts the entitlement premise without question. It treats “aiding millions” as morally self-evident while ignoring the coercion necessary to fund that aid. Government assistance does not materialize from thin air. It transfers responsibility, money, and risk from one group of Americans to another.

Once imposed, that transfer only grows.

Both rejected plans would have sent more taxpayer money to insurers than the ACA already guarantees. With no deal in sight, the Journal observed last month that hope for extending the subsidies is fading. That assessment may be accurate politically, but an extension does not deserve hope. It deserves scrutiny.

How entitlement politics works

Democrats want Republicans to extend an expansion they never voted for of a program they never supported. Republicans respond by proposing modest adjustments to reduce political damage without challenging the underlying structure.

Rep. Max L. Miller (R-Ohio), who voted for the bill, summarized the dilemma perfectly. “I just want to make this abundantly clear: This is a Democratic piece of legislation. It is absolutely horrific. Now, it is the best alternative to what we have at the moment.”

That is how entitlement traps operate.

For decades, big-government advocates have followed a reliable strategy. They create a benefit for a defined group, allow costs to spiral, then dare the opposition to take something away from a newly entrenched constituency. When the moment arrives, those who claim to favor limited government retreat or propose cosmetic reforms that leave the core system untouched.

That dynamic explains why the country remains locked into the socialist ratchet, the uniparty routine, and a political class that acts as tax collector for an ever-expanding welfare state.

RELATED: Democrat senator makes stunning admission about Obamacare failures

Photo by Chip Somodevilla/Getty Images

Trapped voters, trapped taxpayers

Entitlements squeeze the nation from both sides. They trap recipients by discouraging work and mobility, and they trap taxpayers by locking future governments into permanent obligations.

The Affordable Care Act stands as one of the most powerful modern examples of this system. The law forced millions into government-regulated insurance markets while guaranteeing insurers a growing pool of subsidized customers. The result was predictable: higher costs, deeper dependency, and a massive political constituency invested in permanent expansion.

Not a single Republican voted for the ACA. They understood what the law would do. Democrats passed it anyway, and it worked exactly as designed.

Who Obamacare was really built to serve

As Connor O’Keeffe has argued at Mises Wire, federal health care policy has long served industry interests. Government interventions channel money toward providers, pharmaceutical companies, and insurers under the guise of helping patients.

Obamacare accelerated that process by mandating coverage and expanding what insurers must provide, driving demand and cost growth in tandem. Once people rely on government assistance to afford insurance, any reduction becomes politically unthinkable.

Republicans now scramble to avoid electoral consequences. House Speaker Mike Johnson says the GOP will advance health care proposals without extending subsidies, yet many lawmakers privately admit that only an extension prevents immediate pain ahead of the 2026 midterms.

That admission exposes the trap. Spending limits become cruel. Taxpayer costs disappear from the conversation. Only the next premium increase matters.

Why conservatives keep losing

History explains where this leads. Entitlement debates almost always end with higher spending. Political power depends on payments to voters. Reducing benefits means losing elections.

Progressives act decisively when in power. Conservatives obsess over procedure and restraint, even as the administrative state grows unchecked.

Last week alone offered two examples. The House overturned President Trump’s March 2025 executive order blocking collective bargaining for over a million federal employees, with 20 Republicans joining Democrats. Even Franklin Roosevelt opposed public-sector unions. Modern conservatives could not summon the resolve to block them.

On the same day, Indiana Republicans declined to redraw their congressional map despite the risk of losing the House and triggering impeachment proceedings against Trump. They clung to unwritten norms while their opponents prepared to exploit the outcome.

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This pattern defines conservative failure. Republicans manage decline. They preserve a decaying system rather than reverse it.

Donald Trump broke from that habit. A former Democrat, he understands power. Win elections, then act. Trump restored a political energy absent on the right for decades.

His approach to entitlements focuses on restraining growth outside Social Security while expanding private-sector freedom to increase economic output. The goal is not austerity. It is to shrink government’s share of the economy by growing everything else faster.

Reform or collapse

That strategy may succeed or fail. It remains the only alternative to collapse. Without reform, federal spending and debt will overwhelm the system within a decade, possibly sooner. Borrowing costs will explode. Inflation will surge. Control will vanish.

The United States approached that danger under unified Democrat control and Joe Biden’s autopen in 2021 and 2022. Voters halted the slide by electing Republican majorities and returning Trump to the White House.

Trump failed to drain the swamp in his first term, largely because congressional Republicans refused to legislate when they had the chance. In his second term, he has advanced reforms through executive action. Congress has responded with delay and timidity.

The country will escape the entitlement trap one way or another. Reform can arrive through disciplined growth and economic expansion, or through collapse driven by massive overspending.

With their conservative approach to governance, Republicans remain an impediment to the necessary reforms and are working hand in hand with Democrats to bring on that collapse. Time is not on our side.

For once, Medicare is trying something that actually saves money



Medicare is the second-largest program in the federal budget, topping $1 trillion last year. In 2023, it accounted for 14% of federal spending — a share projected to reach 18% by 2032. After years of ballooning costs, something is finally being done to slow the growth. A new Medicare pilot program, the Wasteful and Inappropriate Service Reduction model, borrows a successful private-sector tool: prior authorization. And that’s good news.

Medicare Part B premiums now sit at $185 per month — up 28% from five years ago and a staggering 76% since 2015. Last year, 12% of the 61 million Americans enrolled in Part B spent more than a tenth of their annual income on premiums. That burden is unsustainable.

In a system as expensive and fragmented as ours, no one can afford to keep writing blank checks for low-value care.

WISeR, set to launch in Ohio, Texas, Washington, New Jersey, Arizona, and Oklahoma, will require prior approval for a short list of “low-value” services — procedures that research shows are frequently overused, costly, and sometimes harmful.

To some, the idea of Medicare reviewing certain treatments before covering them may sound like red tape. But when done correctly, prior authorization is not a barrier. It is a guardrail — one that protects patients, improves quality, and helps ensure that both tax dollars and premiums are spent appropriately.

The goal of WISeR is simple: Cut unnecessary treatments and shift resources toward more effective, evidence-based care. Critics warn about the possibility of delays or extra paperwork, and those concerns are worth monitoring. But they don’t negate prior authorization’s potential to make U.S. health care safer, more efficient, and more financially stable.

Prior authorization directly targets some of the most persistent problems in health care. Medicare spends billions each year on low-value services. A 2023 study identified just 47 such services that together cost Medicare more than $4 billion annually. Those are taxpayer dollars that could be put to better use.

The private insurance market shows the same pattern: unnecessary imaging, avoidable specialist referrals, and brand-name drugs chosen over generics all contribute to rising premiums. Prior authorization, when used properly, reins in this waste by ensuring coverage lines up with medical necessity and evidence-based best practices. Research from the University of Chicago shows that Medicare’s prior authorization rules for prescription drugs generate net savings even after administrative costs.

Consider one striking example. Medicare Part B covers wound-care products known as skin substitutes. But an Office of Inspector General report found that expenditures on these products skyrocketed over the past two years to more than $10 billion annually. Meanwhile, Medicare Advantage plans — which rely heavily on prior authorization — spent only a fraction of that amount for the same treatments.

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More importantly, prior authorization helps promote evidence-based medicine. It curbs outdated clinical habits and reduces financial incentives to overtreat. Health plans consistently say that prior authorization aligns care with gold-standard clinical guidelines, particularly in areas prone to misuse.

Of course, the system must be designed responsibly. A well-functioning PA process should be transparent, fast, and grounded in strong clinical evidence. Decisions should be made in close coordination with the patient’s treating provider. The appeals process must be straightforward. And both public and private payers should be held accountable for improper denials or harmful delays.

When structured this way, prior authorization is far more efficient than the current “pay-and-chase” model, where Medicare pays first and tries to recover improper payments later.

Prior authorization already works in the private sector. It can work in Medicare.

Public and private payers have an obligation to steward the dollars they spend — whether those dollars come from taxpayers or premium-payers. In a system as expensive and fragmented as ours, no one can afford to keep writing blank checks for low-value care. When implemented wisely, prior authorization keeps coverage aligned with medical necessity, elevates the value of care, and helps deliver better outcomes at a sustainable cost.

Cutting Government Spending Does Not Have To Be Political Suicide

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The budget hoax that nearly sank Trump’s biggest win (so far)



Conservatives are celebrating a once-in-a-generation legislative triumph with the passage of the One Big Beautiful Bill Act, signed into law on July 4 by President Trump. But the victory almost didn’t happen — thanks to what can only be described as the “budget hawk hoax,” a long-standing tactic used by phony conservatives to block meaningful reforms from becoming law.

The heart of this hoax is that the overriding problem facing America is “the deficit crisis” — and that nothing else on the conservative agenda can ever be moved forward until we deal with it.

Too many conservatives have fallen for the 'budget hawk hoax' for far too long.

But when the conversation turns to cutting wasteful spending, these same so-called budget hawks introduce a poison pill: the notion that the only serious way to reduce the deficit is by gutting Social Security and Medicare — before touching any other government waste.

They know this is a nonstarter — and we all know it’s a nonstarter — because there is no way voters will ever allow Nana’s Social Security to be cut while we’re still using taxpayer money to fund LGBTQ+ programs in Nepal and Botswana.

The impossible dream?

Even worse, the faux-conservative “budget hawks” have generally dismissed any efforts to cut other wasteful government spending, insisting that it would have been a mere insignificant drop in the bucket. Yet when President Trump tried to secure $5 billion in funding for the border wall in his first term, budget hawks protested that we couldn’t afford it.

When the Trump administration began dismantling corrupt NGOs under USAID, legacy “conservative” media scoffed at the effort because it didn’t yield massive dollar savings. Yet if we don’t eliminate such foundational waste first, long-term entitlement reform has no credible path forward.

The truth is, of course, that Conservatism Inc. was just desperately trying to protect the corrupt status quo, keep left-wing spending in place, and deny any spending that advances the conservative agenda.

The same old playbook was rolled out again with the One Big Beautiful Bill Act. Critics labeled it “budget-busting,” but that claim was misleading. The bill didn’t increase spending. In fact, it prevented a scheduled tax hike that would have rolled back Trump-era tax cuts and restored pre-2017 rates.

RELATED: The reality behind this week’s One Big Beautiful Bill spectacle

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To be fair to the bill’s critics, the history of omnibus bills is fraught with corruption. Typically, omnibus bills have been legislative horse trades: Republicans secure pork for their districts, and Democrats secure massive expansions of the welfare state. But the One Big Beautiful Bill Act is different. It actually slashes major government spending in ways that align with long-standing conservative demands.

For instance, the $7,500 federal incentive for electric vehicle purchases is set to expire almost immediately. Under the old playbook, such a subsidy would have increased in exchange for some infrastructure funding in a red district. Not this time.

By trying to defeat the One Big Beautiful Bill Act, “budget hawks” were actually striving to protect and perpetuate the following left-wing agenda items, all in the name of “fiscal conservatism”:

  • A massive tax increase, restoring Obama-level tax rates.
  • Allowing able-bodied Medicaid recipients to continue taking welfare without being required to work.
  • Maintaining all the federal EV rebates and green energy incentives, which are designed to deny Americans the right to affordable energy and reliable transportation.
  • Blocking border security by denying funding for the border wall, additional detention centers, and additional Border Patrol staffing.

It’s even more obscene when you consider the enormous cost to taxpayers of providing social services for illegal aliens — services the “budget hawks” are trying to save — while also perpetuating open borders because “we can’t afford” measures to seal the border.

Too many conservatives have fallen for the “budget hawk hoax” for far too long, accepting that we cannot have any conservative victories so long as we have a national debt. Perhaps that day has finally ended.

Yes, our country’s fiscal crisis is real, and it will persist. But forsaking any victories over the left because of the deficit is not a matter of high principle. It’s simply surrender.

The “budget hawks” will never be able to fix the deficit. They don’t want to. But given the chance, they would continue to use the issue to prevent real conservatives from ever passing useful legislation.

The hoax failed

They lost this round — and thank heaven for that!

The One Big Beautiful Bill Act stops income tax hikes in their tracks. It strips funding from Planned Parenthood, rogue judges notwithstanding. It shuts down the EV grift. It tightens border security and reins in Medicaid fraud.

This is what winning looks like — and the self-styled “budget hawks” hate it. Why? Because it derails the left’s agenda and puts the public back in charge.

Credit goes to President Trump and Speaker Johnson for delivering this landmark victory. And to Stephen Miller — relentless as ever — for making sure the truth broke through.

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