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States should implement creative Medicaid reforms, expert says | National

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www.thecentersquare.com – Thérèse Boudreaux – (The Center Square – ) 2025-05-10 07:09:00


Congressional Republicans are exploring ways to reduce Medicaid spending as part of financing President Trump’s $5.8 trillion budget framework, which demands $880 billion in cuts from the Health and Commerce committee over ten years. Medicaid costs $900 billion annually, with the federal government covering two-thirds. Experts debate whether cuts would hurt states or recipients, but groups like the American Legislative Exchange Council (ALEC) highlight state reforms that reduce spending. States face financial strain, especially those with expanded Medicaid eligibility under the Biden administration, which increased spending by 20%. Possible reforms include fraud prevention, managed care, and work requirements, though public opposition to cuts remains strong.

(The Center Square) – As congressional Republicans struggle to find ways to reduce federal spending on Medicaid without affecting vulnerable people, some have eyed shifting part of the cost burden onto states.

To finance President Donald Trump’s expensive priorities laid out in the Republican $5.8 trillion budget reconciliation framework, which includes extending the 2017 Tax Cuts and Jobs Act, House committees must find varying levels of spending cuts in other areas of the federal government.

Energy and Commerce, the House committee that oversees Medicaid, must find $880 billion in spending reductions over the next ten years, or about $88 billion per year. Even though the bill does not specify where the committee must find the money, the Congressional Budget Office estimates that $581 billion of those savings must come from Medicaid. 

Medicaid costs roughly $900 billion taxpayer dollars per year, with the federal government shouldering roughly two-thirds of that spending and state governments covering the rest.

With experts split on whether federal spending reductions in the program would necessarily harm state budgets and needy recipients would necessarily, the American Legislative Exchange Council is highlighting some successful state reforms that have lowered Medicaid spending.

ALEC Health and Human Services Task Force Director, Brooklyn Roberts, told The Center Square that the existing budget reconciliation activities provide a rare opportunity to “open up the hood” on Medicaid spending and sustainability, both on the federal and state level. 

“States are the laboratories of democracy, and I think they can innovate and figure out ways to set up their programs and save money if we just give them the freedom to do so,” Roberts said. “We’re not really taking a position on what the reforms are going to look like at the national level; we’re focused on how the states can adapt to whatever happens on the federal side.”

Under the Biden administration, Medicaid spending shot up 20% and expanded program eligibility beyond low-income seniors; families with children; and pregnant mothers with their infants to able-bodied, childless adults. This means that even if Republicans find all $880 billion in savings via Medicaid cuts, federal funding to the program will still grow, just at a slower rate.

But given that most states have also expanded Medicaid eligibility – and many are now struggling under that burden – program reforms can help states adjust to whatever changes happen at the federal level.

“A lot of states, especially states that have expanded Medicaid, are facing these huge financial challenges trying to shoulder the full cost,” Roberts said. “It’s almost a third of most state budgets. So they need to be looking at what types of services they’re providing and then making sure that coverage is going to the people who truly need it.”

A large part of that includes identifying and preventing improper payments and fraud, she said.

“You’ve got Indiana, who just passed SB2, that is focusing on program integrity and making sure that the people who are on the program are the people who truly should be. That requires yearly eligibility verification, [and] it requires that those verifications are matched against federal databases, which are the strongest predictor of fraud.”

Besides simply rolling back Medicaid expansion, other cost-cutting options available include transitioning over to a managed care type of system, like Idaho is considering, or implementing work requirements for some recipients, like Arkansas is doing.

“Medicaid is not a permanent solution – it’s supposed to help people transition to private and other insurance,” Roberts said. “[States] need to be working at looking at the types of reforms that best fit their population.”

Americans are wary of any major changes to the program that more than 71 million rely on for healthcare coverage. The Center Square’s Voters’ Voice poll, one of only six national tracking polls in the United States, shows that the vast majority of Americans do not want any spending reductions to Medicaid.

The post States should implement creative Medicaid reforms, expert says | National appeared first on www.thecentersquare.com



Note: The following A.I. based commentary is not part of the original article, reproduced above, but is offered in the hopes that it will promote greater media literacy and critical thinking, by making any potential bias more visible to the reader –Staff Editor.

Political Bias Rating: Center-Right

This article provides a balanced report on the debate surrounding Medicaid spending, but it leans slightly to the right in its presentation. The content highlights the challenges faced by state governments in managing Medicaid costs, particularly in states that expanded eligibility under the Biden administration. It emphasizes the need for reforms, mentioning conservative-leaning organizations like ALEC, and features a viewpoint that states should have more flexibility to design their own Medicaid programs. The article also discusses cost-cutting measures, such as work requirements and managed care, which align with conservative policy preferences. However, it avoids explicitly advocating for any particular reform, presenting multiple perspectives without overt bias toward one side. The use of expert testimony from Brooklyn Roberts, a director at ALEC, further tilts the narrative toward conservative viewpoints on Medicaid. The piece refrains from deeply critical language about potential Medicaid cuts, focusing instead on how states might cope with federal changes.

The Center Square

First U.S.-China meeting amidst trade war unlikely to yield major changes, economists say | National

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www.thecentersquare.com – Morgan Sweeney – (The Center Square – ) 2025-05-09 22:05:00


The U.S. and China are meeting for the first time since their trade war began, sparked by tariff increases from both sides. While President Trump raised tariffs on many trading partners in April, China responded with its own tariffs, escalating tensions. Economists view the upcoming meeting skeptically, seeing it as a preliminary step rather than a breakthrough. Past efforts, like the 2020 ‘Phase One’ deal, failed to resolve deeper issues like forced technology transfers and state subsidies. Political and economic challenges in both countries complicate negotiations. Analysts expect a long, difficult path toward any substantial trade agreement, with possible tariff reductions being tentative at best.

(The Center Square) – The U.S. is set to meet with China for the first time in the trade war begun just over a month ago, and while it could lead to real negotiations down the road, many observers see it as a preliminary meeting.

President Donald Trump raised tariffs with many of America’s trading partners, including China, on April 2, causing many countries to reach out to the U.S. to negotiate trade deals, according to the administration (though the White House has only shared the framework details of one deal made with the United Kingdom). But China chose to raise its tariffs in response, sparking a trade war that has resulted in a 145% tariff on Chinese imports to the U.S. and a 125% tariff on American goods imported to China.

Trump has said he has been talking with Chinese President Xi Jinping, but neither country had released any details about those conversations, and China denied they happened. Several economists The Center Square spoke to weren’t optimistic that the meeting would yield big results. 

“By all accounts that we can locate, it appears that it’s a meeting to talk about a meeting,” said director of education and senior research fellow at the American Institute for Economic Research, Ryan Yonk.”Which isn’t a big surprise. That’s how these things tend to begin, where behind the scenes, there is movement likely on both sides… to begin to talk about how will they actually set up a way to have more formal discussions.’”

Alex Durante, a senior economist at the Tax Foundation who previously worked for the Federal Reserve Board and the Council of Economic Advisers, agreed. 

“I think it’s possible that maybe both sides reach some kind of agreement and tariffs maybe on certain kinds of goods are lowered or removed, but I’m a bit skeptical that we’re going to get something very remarkable,” Durante told The Center Square.

Part of the skepticism is due to an episode of déjà vu – the first Trump administration also had specific aspirations for U.S.-China trade relations which largely never materialized. Trump also raised tariffs on China then to establish a better trade relationship. China, as it has now, responded in kind. In January 2020, the Trump administration signed the ‘Phase One’ trade agreement, which included commitments from China to increase U.S. imports by $200 billion and strengthen protections on intellectual property. But China ultimately fell short of its purchasing commitments, partly due to the pandemic. Trump had also sought to further address non-tariff barriers such as forced technology transfer and state subsidies, but those deeper issues remained unresolved.

“They never got to some of the real issues – that is, the problems of the state capitalism characteristics that really hamper trade and investment with not just the United States but others – the kinds of things about technology transfer, about subsidies, about favoritism to state-owned companies,” said Claude Barfield, a senior fellow at the American Enterprise Institute and a former consultant to the office of the U.S. Trade Representative.

Some of these issues were spoken about in a congressional hearing earlier this year that focused on the Chinese Communist Party’s influence on American investment. China reportedly pressures companies to share proprietary technology to gain access to the Chinese market, and it employs other business practices in its international deals that don’t comply with World Trade Organization regulations.

More skepticism comes from the fact that both sides have invested far more than merely economics in the outcome of their negotiations.

“You [have] two regimes that are unlikely to make decisions on pure economic outcomes, as much as we think they should,” Yonk told The Center Square. 

China has undergone a marked real estate crisis and faces other economic challenges, and the U.S. is adjusting to new economic policies under the Trump administration, the after-effects of a jarring inflationary period and the looming question of a recession.

“There’s been massive capital investment [in China] that really hasn’t panned out in the way they expected,” Yonk said. “In large part, China had messaged their legitimacy by what they could deliver economically. When that changed, there was a pivot to more Chinese nationalism as the justification, which means it’s no longer about just getting an economic deal that’s going to work for China, there’s also now a much more nationalistic question that’s on the table about respect and sort of world influence.”

Barfield also described economic problems in both countries. Xi has “internal issues,” Barfield said, while Trump, elected for his economic policies, faces pressures at home. 

“Has he done things to help him on the issues that got him elected?” Barfield remarked to The Center Square. “Certainly, throwing tariffs all around the world isn’t going to help. We don’t know yet, but it may not end up in inflation over the whole U.S. economy rather than just sort of price hikes in different sectors, but it’s something he and his people are now worried about.” 

The administration has acknowledged the existing rates are unsustainable, but it’s unclear which side will make concessions first.

“I think it’s a bit of a pick ‘em [whether] one side or the other gives in first, and I actually think we’re not likely to see evidence that one side or the other did. I think both sides will claim the other did and the question will be, can the other side accept that narrative and still go forward with some sort of trade deal. I think it’s gonna be a long road to a trade deal with China that is really sort of substantial and far-reaching,” Yonk said.

Trump did post to Truth Social on Friday, saying a lowered 80% tariff on China “seems right” but that it was up to Treasury Secretary Scott Bessent, but this was after saying earlier in the week that the U.S. would not lower tariffs on China to prompt concessions from the Chinese.

“I think the best outcome would be sort of a cooling off period, if they agree to actually have discussions after Saturday,” Yonk said.

The post First U.S.-China meeting amidst trade war unlikely to yield major changes, economists say | National appeared first on www.thecentersquare.com



Note: The following A.I. based commentary is not part of the original article, reproduced above, but is offered in the hopes that it will promote greater media literacy and critical thinking, by making any potential bias more visible to the reader –Staff Editor.

Political Bias Rating: Centrist

The article primarily reports on the ongoing U.S.-China trade negotiations and related economic policies without advocating for a specific ideological stance. It presents statements from multiple experts with varied perspectives, describing skepticism about the outcomes and detailing both sides’ actions and challenges. The language remains factual and neutral, focusing on analysis and reporting rather than promoting a partisan point of view. The piece discusses concerns about tariffs, economic and political factors, and historical context evenly, adhering to a balanced and informative tone typical of neutral reporting.

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The Center Square

CA’s estimated $10B deficit ‘precisely’ matches illegal immigrant health care cost | California

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www.thecentersquare.com – Kenneth Schrupp – (The Center Square – ) 2025-05-09 18:00:00


California faces a $10 billion-plus deficit even if tax revenues hold steady, driven by higher-than-anticipated spending. Critics link this shortfall to the state’s expansion of Medi-Cal eligibility to illegal immigrants, which is estimated to cost $10 billion. The Legislative Analyst’s Office warns the economy is “stagnant” and reliant on an “unsustainable” stock market, with a fragile outlook amid potential consumer sentiment declines. Last year, California closed a $73 billion deficit through cuts and reserves. Rising mandatory costs like Medi-Cal, combined with possible federal funding cuts, may cause another shortfall. Despite claims of economic strength, job losses and weaker tax revenue persist.

(The Center Square) – California legislators have been told to expect a deficit of $10 billion or more even if revenues do not fall due to higher than anticipated spending, reports Politico.

Critics note that the $10 billion figure matches estimated costs of the state’s expansion of eligibility for Medi-Cal, the state’s taxpayer-financed health care system, to all income-qualifying illegal immigrants. 

“What a fiscal coincidence: precisely the estimated cost of Gavin Newsom’s plan to extend state Medi-Cal to illegal immigrants,” said Will Swaim, president of the conservative California Policy Center on X. 

Earlier this week, the state-funded Legislative Analyst’s Office warned the state’s economy is “stagnant” and “fragile” and that the budget is reliant on an “unsustainable” stock market. Earlier Friday, the LAO urged lawmakers to consider the possible negative downturn that tends to but does not always accompany significant decreases in consumer sentiment. 

“If hard economic data fall in-line with worrisome economic indicators, the state’s revenue outlook will turn more negative; however, recent history suggests this outcome is far from certain,” wrote the LAO. “As such, we urge policymakers to weigh the risks of both the possibility of a further downturn and of better than expected growth when making budget decisions.”

Last year, the state narrowly closed a $73 billion deficit through a combination of spending cuts, deferrals, shifts, and reserve withdrawals. 

Now, even if state tax revenue remains steady, rising non-discretionary spending, such as from Medi-Cal, combined with possible cuts or funding withholding at the federal level could leave the state billions of dollars short yet again. 

Federal spending in California is set to be $171 billion this year.

In February, state officials said California had spent $9.5 billion thus far on Medi-Cal services for illegal immigrants, The Center Square first reported, resulting in California Gov. Gavin Newsom requesting a $6.4 billion emergency bailout to fund the program for the remainder of the fiscal year. 

In April, Newsom bragged about the strength of the California economy, sharing it’s now the world’ fourth-largest economy in U.S. dollars — due to the relative decline of the Japanese yen to the dollar. After accounting for the high cost of goods and services, California only barely edges out low-performing Italy, and the state has shed hundreds of thousands of private sector jobs amid lower projected sales and corporate tax revenue. 

The post CA’s estimated $10B deficit ‘precisely’ matches illegal immigrant health care cost | California appeared first on www.thecentersquare.com



Note: The following A.I. based commentary is not part of the original article, reproduced above, but is offered in the hopes that it will promote greater media literacy and critical thinking, by making any potential bias more visible to the reader –Staff Editor.

Political Bias Rating: Center-Right

The article leans toward a Center-Right bias, primarily through its critical framing of California’s fiscal issues and the expansion of Medi-Cal to illegal immigrants. The tone of the article emphasizes the state’s financial strain, with criticisms from conservative voices like Will Swaim of the California Policy Center, who links the budget deficit directly to the cost of extending Medi-Cal. The article also highlights concerns about unsustainable spending and economic fragility, using language that suggests an ongoing fiscal crisis. While it reports facts, the focus on negative economic outlooks, the emphasis on conservative critiques, and the lack of substantial counterbalance to these critiques suggest a leaning towards a more conservative viewpoint on fiscal matters.

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News from the South - Louisiana News Feed

Louisiana lawmakers advance bill to increase oversight of regulatory state | Louisiana

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www.thecentersquare.com – By Nolan McKendry | The Center Square – (The Center Square – ) 2025-05-09 13:04:00


Louisiana lawmakers are considering bills to enhance oversight on state spending and regulation. Senate Bill 59, by Sen. Mike Reese, would require legislative approval for state agency rules with significant fiscal impact, aiming to increase accountability. Meanwhile, SB 184, by Sen. Heather Cloud, targets nonprofit organizations, mandating financial audits and outcome data for those receiving public funds. Governor Jeff Landry has also launched the Department of Governmental Efficiency (DOGE), led by a Fiscal Responsibility Czar, to streamline state operations. While the initiatives seek to improve transparency, critics question their necessity and potential duplication of existing oversight.

(The Center Square) − As Louisiana’s legislative session continues, lawmakers are considering multiple bills aimed at increasing oversight of regulatory actions and tightening the rules for how taxpayer money is spent.

One of the early measures gaining traction is Senate Bill 59 by Sen. Mike Reese, R-Leesville, which would require legislative approval before any state agency rule with a significant fiscal impact — defined as at least $200,000 per year or $1 million over five years — could take effect. The bill passed a key Senate vote and now awaits consideration in the House.

Supporters say the bill would improve accountability by ensuring that major regulatory decisions are reviewed by elected officials. The proposal is similar to the so-called “REINS Act” model being promoted in legislatures across the country.

Under current Louisiana law, agencies must include fiscal impact statements with proposed rules, but they are not always subject to legislative approval. SB 59 would expand that oversight, requiring the fiscal office to assess potential costs and trigger committee hearings for high-impact rules. Emergency regulations would also be subject to additional fiscal scrutiny under the bill.

Meanwhile, another piece of legislation — SB184 by Sen. Heather Cloud, R-Allen — would implement new standards for nongovernmental organizations that receive public dollars.

The bill, which is scheduled for further debate in the Senate Finance Committee, would require recipient organizations to provide detailed financial audits, outcome data, and statements of public purpose before receiving state appropriations.

Nonprofits would also need to be registered in Louisiana for at least one year, keep administrative costs under 15% of expenditures, and maintain a physical office in the state. Groups that fail to submit required documentation could face a five-year ban from receiving state funds.

The legislation would consolidate existing data into a searchable portal through Louisiana’s Checkbook platform to allow the public and lawmakers to better monitor how funds are spent.

“These bills are part of a broader effort to increase transparency and ensure responsible stewardship of taxpayer money,” Cloud said during a recent hearing.

In addition to the legislative activity, Governor Jeff Landry has launched a new initiative—the Department of Governmental Efficiency (DOGE)—tasked with identifying ways to reduce waste and improve performance in state government.

Landry appointed Steve Orlando as Fiscal Responsibility Czar, who is expected to work closely with the Louisiana Legislative Auditor.

A news release from the governor’s office says residents are encouraged to submit suggestions for improving government efficiency via email.

The DOGE initiative has drawn both support and criticism. Supporters see it as a step toward greater fiscal accountability, while critics, including some legislators, question whether it duplicates existing oversight functions already handled by the legislature and the state auditor.

“Legislators create and pass the state’s annual budget, which the governor then signs, with a line-item veto,” Rep. Mandie Landry, D-New Orleans, said in a statement. “A new, bureaucratic entity cannot and should not supersede these constitutional powers.”

The post Louisiana lawmakers advance bill to increase oversight of regulatory state | Louisiana appeared first on www.thecentersquare.com



Note: The following A.I. based commentary is not part of the original article, reproduced above, but is offered in the hopes that it will promote greater media literacy and critical thinking, by making any potential bias more visible to the reader –Staff Editor.

Political Bias Rating: Center-Right

The article primarily reports on legislative efforts and government initiatives in Louisiana aimed at increasing oversight, fiscal responsibility, and transparency in spending. The tone is factual and includes statements from both supporters, including Republican lawmakers and Governor Jeff Landry, and critics, such as a Democratic representative. However, the focus on regulatory tightening, fiscal scrutiny, and government efficiency aligns more closely with conservative, center-right priorities emphasizing limited government oversight and financial accountability. The language is measured and not overtly partisan, maintaining a mostly neutral reporting style without promoting an ideological agenda, but the content’s framing suggests a center-right perspective based on the topics covered and the officials highlighted.

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