For too long, Medicaid debates have been stuck: one side pushes cost cuts, the other pushes access — and little changes.
This plan does both by focusing on integrity, access, and accountability.
🔍 Integrity & fraud prevention
✅ Real‑time eligibility checks using wage, death, and benefits databases
✅ Immutable audit trails for every approval and denial
✅ Targeted enforcement against high‑risk billing — not paperwork mistakes
💼 Work & skills support (with protections)
✅ Connect able adults to jobs, training, education, or recovery supports
✅ Automatic exemptions: medical, caregiving, postpartum, students
✅ “Good cause” protections so admin errors don’t end coverage
🏥 Primary care first
✅ Pay primary care at Medicare rates; bonus for same‑week appointments
✅ Integrate behavioral health and community health workers
✅ Reward outcomes (prevention, chronic care) — not just more visits
💊 Pharmacy & price transparency
✅ Ban PBM spread pricing; pass rebates back to Medicaid
✅ Publish de‑identified service prices by county
✅ 48‑hour “deem approved” for appropriate generics/biosimilars
🌾 Rural access & telehealth
✅ Global budgets to stabilize rural hospitals and clinics
✅ Telehealth parity (including audio‑only when appropriate)
✅ Mobile clinics for dental, vision, and primary care
🧠 Mental health & recovery
✅ Same‑day billing for primary + behavioral health
✅ Coverage for MAT, intensive outpatient, and peer support
✅ Crisis continuum: 988 integration, mobile teams, stabilization
📊 Radical transparency
✅ Public dashboards: enrollment, wait times, outcomes, spending
✅ Publish all managed care and PBM contracts
✅ Public complaint tracker with resolution timelines
💡 Fiscal guardrails
✅ Per‑capita growth targets tied to medical CPI (risk‑adjusted)
✅ Reinvent savings: ≥ 50% to primary careworkforcerural access
✅ Independent evaluation and 5‑year sunset unless benchmarks are met
🙋 What this means for you
For families
✅ Faster approvals and fewer paperwork headaches
✅ More primary care, behavioral health, and rural services
✅ Continuous coverage protections to reduce churn
For taxpayers
✅ Every dollar verified, every contract public
✅ Fraud prosecuted; savings reinvested where they cut waste
✅ Monthly dashboards so you can “see the receipts”
Bottom line:
We’ll fund the care that keeps people healthy — not the waste that keeps costs rising — and we’ll prove it with public data.