Letter to the Editor WSJ: Work With the Bureaucracy, Not Against It

Originally published at Wall Street Journal. 

​Messrs. Musk and Ramaswamy’s proposal for the Department of Government Efficiency, or DOGE, presents a promising opportunity to restore constitutional governance. A clear path for reform exists within Medicaid: Enforce Section 1801 of the Social Security Amendments of 1965 that created Medicaid.

This law prohibits federal control over both medical care and how a state operates its Medicaid program. Yet decades of overreach have transformed Medicaid from a limited safety net to an unwieldy program covering 92 million Americans, encouraged by the flawed formula that rewards overspending.

By rescinding federal regulations and limiting federal involvement to block grants, DOGE can return control to states, saving taxpayers billions. Implementing Section 1801 requires no new law. An executive order enforcing existing statutes would suffice. This aligns with DOGE’s objectives of regulatory rescission, administrative reduction and cost savings while upholding constitutional principles.

​Deane Waldman and Vance Ginn
Round Rock, Texas.