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Medicaid was built to be a safety net for the vulnerable—low-income kids, seniors, pregnant women, and the disabled. But Washington has turned it into a bloated mess that prioritizes able-bodied adults and rewards fraud over genuine care.

Thanks to policies like Obamacare’s Medicaid expansion, states receive a 90% federal match for able-bodied, working-age adults, while the match for the truly vulnerable is only 60%. It’s like trying to build a second floor on a house with a cracked foundation.

Meanwhile, South Carolina is doing it right—keeping eligibility tight and focusing on those who need help the most. But our taxpayers are still footing the bill for the waste and abuse happening in other states. California, for example, uses “provider taxes” to launder fake state dollars into massive federal payouts, then turns around and expands Medicaid to illegal immigrants!!

Today, over 94 million Americans are on Medicaid, and improper payments have surpassed $1.1 trillion over the last decade. This is simply not sustainable.

That’s why, earlier this week, I joined several of my colleagues in signing a letter urging Congress to include real Medicaid reform in the upcoming budget reconciliation package. We need to patch the holes, reinforce the foundation, restore integrity, and rebuild a system that protects the truly vulnerable.