Medicaid Overspending Spurs Push for Reform in the States: Brooklyn Roberts on NewsTalkSTL

During a recent interview with NewsTalkSTL hosts Tim Jones and Chris Arps, Brooklyn Roberts, ALEC Health and Human Services Senior Task Force Director, discussed Medicaid reform and expansion as it relates to the ongoing discussion of legislation on Capitol Hill.

Roberts emphasized that while cuts are inevitable, they must be coupled with long-term structural improvements. “I think some of the items that are in this bill may save more money over the long run than some of the options they were talking about before,” she said, referring to the revised Medicaid proposal that reduces projected savings from $850 billion to $775 billion.

Roberts traced the origins of Medicaid to its creation in the 1960s as a targeted safety net.

“It was a social safety net that was created to provide care for pregnant women, children, and the disabled—the truly vulnerable people in society,” she explained. “And it’s grown so far beyond that.” According to Roberts, the Affordable Care Act’s Medicaid expansion “grew Medicaid into able-bodied working adults, and… the costs have soared. Enrollment has soared, and it’s caused a huge problem for states.”

As states struggle to balance these rising costs, Roberts has been outspoken about the importance of restoring integrity to the program.

“They are trying to clean up the integrity of the program,” she said. “Make sure that the resources are going to the people who truly need it, and that we do have resources in the long term… for pregnant women, children and disabled.”

Roberts stressed that reforms do not necessarily mean slashing vital services.

“There seems to be a debate going on… when those on the right talk about reform and eliminating waste, fraud and abuse, those on the left… hear people wanting to slash and cut and burn the programs,” Jones commented. Roberts replied that “what they are looking for is restoring the integrity of the program, making sure there are regular eligibility checks.”

Pointing to legislation in Indiana as an example, she highlighted SB 2, which “required regular yearly eligibility checks matched against federal databases. That… is the biggest predictor of fraud when it comes to Medicaid eligibility.”

Beyond traditional entitlement reform, Roberts is also keeping a close eye on the evolving role of artificial intelligence in healthcare.

“AI shows so much promise in terms of diagnostics and on the administrative side in healthcare,” she said. “It should be seen as a tool and not as a replacement for doctors.”

Roberts warned that while AI can enhance efficiency, it must be implemented responsibly. “We have to be very careful that anything we’re doing with AI is not endangering patients.”

Staffing shortages in healthcare—exacerbated, she argues, by Medicaid expansion—also demand attention. “There are a lot of doctors who either cannot take any more Medicaid patients because reimbursement rates are low, or just can’t serve any more patients than they’re already serving,” she said.

ALEC has responded with model policy addressing international licensing to help combat the provider shortage, which Roberts describes as one of the most pressing issues keeping her up at night.

“The overall healthcare system is such a big part of our economy,” she said. “Reforms that put control back into patients’ hands are so critical and so important.”