Floor Remarks by Senator Chuck Grassley of Iowa
Senate President Pro Tempore
“2025 Tax Bill and Medicaid”
Thursday, October 23, 2025
First of all, I want to compliment the chaplain. [In] each one of his prayers this week, he’s [discussed]...the importance of opening up the government and ending the Schumer Shutdown.
I come to the floor today to speak about the Department of Health and Human Services’ Inspector General routinely issuing recommendations to improve the operation of health care programs and to produce savings for the taxpayers.
Until this year, two very important and top Department of Health and Human Services Inspector General recommendations were unaddressed, and they should have been addressed, because these are egregious wastes of taxpayers’[money].
Number one, the report says we should stop duplicate enrollment on two or more state Medicaid programs of individuals.
And second, stopping Medicaid payments for enrollees who have passed away.
The tax bill signed by President Trump on July 4 puts an end to this fraud, waste and abuse in the Medicaid program. That legislation establishes solutions to stop duplicative enrollment and sending payments out for deceased enrollees and providers. Once implemented, I hope these recommendations of the Inspector General are satisfied.
Let me give some examples and reasons why these reforms are necessary.
In July, the Centers for Medicare and Medicaid Services (CMS) found 2.8 million Americans were enrolled in two or more Medicaid or Federal Marketplace plans.
It’s quite obvious that any enrollee only needs one insurance plan or Medicaid, not both, to satisfy their healthcare options.
Is this duplicative enrollment a new discovery? No. Previously, the Department of Health and Human Services Inspector General has found that nearly all states have paid managed care insurance companies for enrollees who were enrolled in two different state Medicaid programs.
In another example, in August, a Louisiana Medicaid program audit found that 9.6 million dollars was paid out for deceased enrollees in that Medicaid program. In other words, showing how stupid it is to pay for healthcare for people who have died.
Now, do you think Louisiana is an isolated incident? No, it is not an isolated incident. In the past decade, the Department of Health and Human Services Inspector General has uncovered similar fraudulent payments paid out for deceased enrollees in 17 states.
In addition, state Medicaid programs have been uncovering fraud, but at the same time, failing to return the correct refund amount to the federal government. Last year, four states were found by the department of Health and Human Services Inspector General for failing to report and return federal Medicaid overpayments.
Using the resources established in the 2025 tax bill, we will put a stop to this and save taxpayers over $24 billion over 10 years.
While this action might seem like common sense, you’ve heard me say so often that Washington, D.C. is an island surrounded by reality. Duplicative enrollment, payments for deceased enrollees and failing to return federal money correctly is a stiff to the taxpayers every time it happens.
With these savings, we can protect Medicaid resources for the reason that Medicaid was set up: to help vulnerable Americans like the disabled, like the elderly, like pregnant women, like children and many more groups of people you can name.
So, common sense will now prevail as a result of the changes that the Congress has made in that 2025 tax bill that Congress passed and the president signed on July 4.
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