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EXCERPT:
Medicaid is federally funded and state-run, but the program’s beneficiaries often have the least say in who provides their care and what that care costs.
That’s a built-in flaw. States have every incentive to maximize federal matching funds while federal taxpayers bear much of the cost. The result pits state bureaucrats against Washington’s need to control Medicaid spending — and against taxpayers’ interest in stopping providers, insurers, and contractors from cashing in on weak oversight.
New York’s home-care scandal is not merely a contracting failure. It is a warning about Medicaid’s overall design.