NC Congressman: Our country needed the Medicaid reform the Big Beautiful Bill provided | Opinion

My life’s work has been in service to the patients of Eastern North Carolina and as a medical missionary abroad. Throughout my tenure in the state General Assembly and Congress, I have never ceased to identify as a doctor first. Despite congressional rules preventing me from keeping any income, I still see patients a few times a month.

As the only practicing physician in Congress, no one better understands the stakes of Medicaid reform than I do. I have served Medicare, Medicaid and uninsured patients from across our rural referral area for over 30 years and now represent many of them in Congress.

Throughout the legislative process of H.R. 1, the One Big Beautiful Bill (OBBB), I fiercely advocated for a targeted approach to protect benefits for those who are most vulnerable and deserve a helping hand; the very type of people Medicaid is designed for. In fact, the day before we passed the budget reconciliation package, I spoke with President Donald Trump to share Eastern North Carolina’s story and the challenges our communities face.

Regrettably, the intensity of America’s political environment perversely incentivizes politicians, media outlets and influencers to stoke fear. Without shame, Democrats breathlessly attacked Republicans as soulless miscreants who wish to strip access to health care for millions of needy Americans. In reality, we acted to preserve the financial viability of a critical program, which has seen costs grow by 51% since 2019, that our constituents rely on.

The Medicaid reforms accomplished through OBBB targeted three areas where recent lax eligibility enforcement has caused Medicaid to balloon in recent years: eligibility verification, illegal immigrants and able-bodied Americans without dependents who refuse to work. Just this month, the Center for Medicare and Medicaid Services announced they have identified 2.8 million Americans who are enrolled in two or more government subsidized health care plans across different states, costing taxpayers an extra $14 billion a year. Basic safeguards and eligibility checks will save taxpayers billions.

No issue was distorted by Democrats more than prohibiting taxpayer-funded health care for illegal immigrants. While federal law prohibits Medicaid coverage for unlawful residents in the United States, states use their own revenue to cover that population. States that cover unlawful residents should be responsible for making up budgetary shortfalls in other areas instead of extracting funds from the federal government.

Democrats gleefully trained their messaging on the federal prohibition of Medicaid for illegal immigrants to avoid scrutiny of the fact that some states pay for noncitizens health care. There is no better tool to conceal such a scheme than the fungibility of money.

A recent study from the American Enterprise Institute, a respected center-right think tank in Washington, found that unemployed, able-bodied Medicaid beneficiaries spent the same amount of time watching television and playing video games per month as their working counterparts do on the job. America cannot flourish if idleness and societal withdrawal are rewarded and subsidized.

Unless exempted due to a special status such as living with a disability, acting as a caretaker or being raised in foster care, individuals must complete at least 80 hours per month of work or qualified community engagement activities, such as job training, going to school or volunteering. If a non-exempt, able-bodied individual does not meet that threshold, taxpayers should not subsidize their health care coverage.

Medicaid expansion, enacted by the Affordable Care Act, was a laudable effort to cover the working poor such as fisherman, clergy members and those in service sector jobs. I helped lead the creation of the Carolina Cares program while serving in the General Assembly to responsibly effectuate it in North Carolina. However, Democrats have simultaneously worked to relax income and residency checks to determine eligibility. Waste, fraud and abuse run rampant if increased enrollment is coupled with loose eligibility certification mechanisms.

A dollar saved by removing an unemployed freeloader or illegal immigrant off Medicaid is a dollar that can be used to support a struggling single mother, a selfless caretaker or a young adult immiserated by a childhood spent in foster care.

I am proud of the meaningful reforms Republicans enacted to dignify those who need a helping hand, which history will look back on as noble despite the deceit spewed by partisans and fearmongers.

Congressman Gregory Murphy represents the 3rd District of North Carolina in the House of Representatives.