Too often, policymakers are stuck fighting the last war. That’s what is happening in today’s debates over Medicaid . With states facing difficult budget decisions, Medicaid inevitably draws attention because it is the single largest line item in most, if not all, state budgets . But how lawmakers choose to address these pressures will determine whether patients are protected and access to care is preserved, or state governments inadvertently trigger a healthcare access crisis.

The core of this disconnect is flawed Medicaid spending projections that often fail to recognize how much progress is already being made by President Donald Trump, with more to come. Under his leadership, reforms are reshaping the program in ways that will naturally bend the cost curve downward without resorti

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