Thirty years ago this summer, Congress passed the Personal Responsibility and Work Opportunity Reconciliation Act.Welfare reform succeeded because it recognized a simple but powerful truth: Public programs work best when they reward responsibility, accountability, and innovation.States make better decisions when they have both authority and responsibility for the results.
By giving governors greater flexibility while also making them more accountable for the outcomes, we encouraged states to rethink old assumptions, experiment with new approaches, and become better stewards of taxpayer dollars.Good intentions alone do not produce good government.
Incentives matter.That lesson is just as relevant today.TRUMP'S WAR ON FRAUD EXPANDS AS TREASURY LAUNCHES NEW SITE WITH WHISTLEBLOWER INCENTIVESSince returning to office, President Donald Trump has made rooting out waste, fraud, and abuse a hallmark of his administration.Early in that effort, Elon Musk remarked that the Centers for Medicare and Medicaid Services (CMS) was "where the big money fraud is happening." He was right.
Few areas deserve more scrutiny than Medicaid, which involves hundreds of billions of taxpayer dollars and the nation’s largest federal-state partnership.CMS Administrator Dr.Mehmet Oz has made strengthening Medicaid program integrity a national priority, launching a 50-state initiative to improve provider oversight while expanding efforts to combat waste, fraud, and abuse across a range of healthcare services.Those investigations deserve praise.
But they also reveal something much larger than misconduct by a handful of providers.TRUMP TRIES TO CUT BLUE-STATE MEDICAID FRAUD AND SAVE MORE GREENThe real challenge is not simply fraud.It is that Medicaid's current financing structure often creates incentives that make waste, fraud, and abuse more likely while making sustained, effective oversight more difficult.Human nature is predictable.
Whenever government creates a system involving hundreds of ...