July 6, 2026
The Honorable Michael Cloud
304 Cannon House Office Building
Washington, DC 20515
Dear Representative Cloud,
On behalf of National Taxpayers Union, the nation’s oldest taxpayer advocacy organization, I write to express our support for the Medicaid Equal Standards Act. This government-sponsored health care program is in dire need of reform to ensure it remains available for those who truly need it while protecting taxpayers from waste, fraud, and abuse. By establishing a basic asset test for expansion enrollees, this practical measure strengthens Medicaid’s program integrity and helps ensure that federal resources are directed solely to those who are eligible for assistance.
Medicaid was originally designed as a safety-net program to take care of society’s most vulnerable, such as pregnant women, disabled individuals, and low-income seniors. Unfortunately, Obamacare recklessly expanded Medicaid into an open-ended entitlement that made healthy, working-age adults eligible for government-sponsored health insurance. Offering states higher federal matching funds for these able-bodied expansion enrollees has diverted resources from the most vulnerable and helped drive total Medicaid spending to nearly $1 trillion annually.
Medicaid expansion significantly increased the scale and complexity of the federal safety-net, which, in turn, aggravated the longstanding problem of fraudulent and faulty payments. Today, Medicaid ranks among the top five federal programs for improper payments according to the Government Accountability Office (GAO). In fiscal year 2025 alone, the Centers for Medicare and Medicaid Services (CMS) estimated improper payments in Medicaid totaled just over $37 billion, which is nearly a $6 billion increase from the previous year.
Thankfully, Congress addressed some of Medicaid’s most glaring perverse incentives last summer in the Working Families Tax Cuts. Strengthening eligibility verifications for enrollees, cracking down on state-level financing gimmicks and imposing modest work requirements for able-bodied adults will save taxpayers hundreds of billions of dollars over the next decade.
One of the biggest problems with Medicaid expansion is that eligibility determinations for able-bodied adults are based solely on reported income, with no meaningful consideration of an applicant’s assets. As a result, households with substantial accumulated wealth can still qualify for government assistance. Yet, disabled beneficiaries seeking Long Term Services and Supports (LTSS) must pass a stringent asset test before receiving benefits. This double standard needlessly complicates Medicaid and erodes public trust in government.
The Medicaid Equal Standards Act offers a straightforward solution to this discrepancy by requiring able-bodied adults to pass an asset test before receiving benefits. Modeled after Supplemental Security Income (SSI) standards, able-bodied expansion applicants would have to demonstrate they own no more than $10,000 in assets. Importantly, this bill would exempt essentials such as the applicant’s primary residence (including the land it sits on), primary vehicle, and other basic personal property from counting towards the asset calculation. This balanced, targeted approach fixes a gaping hole in Medicaid’s eligibility rules.
Reforming entitlement programs is rarely easy, and the Medicaid Equal Standards Act represents an important step in tackling government profligacy while sticking up for the interests of taxpayers. NTU is proud to support this legislation and looks forward to working with you to help it become law.
Sincerely,
Alexander Ciccone
Policy and Government Affairs Manager
National Taxpayers Union