Opinion

NEWT GINGRICH: Want to reform Medicaid? Accountability is the way forward

Government works best when its rules reward responsibility rather than dependency

By Newt Gingrich Fox News

Published July 29, 2026 7:00am EDT

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SEE IT: Dr. Oz takes aim at Newsom over Medicaid fraud and state oversight

CMS Administrator Dr. Mehmet Oz spoke about Medicaid fraud, saying some blue states have made it a "feature" and criticizing California Gov. Gavin Newsom over his handling of fraud in his state. (Credit: Nicholas Ballasy for Fox News Digital)

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Thirty years ago this summer, Congress passed the Personal Responsibility and Work Opportunity Reconciliation Act. Welfare reform succeeded because it recognized a simple but powerful truth: public programs work best when they reward responsibility, accountability and innovation.

States make better decisions when they have both authority and responsibility for the results. By giving governors greater flexibility while also making them more accountable for the outcomes, we encouraged states to rethink old assumptions, experiment with new approaches and become better stewards of taxpayer dollars. Good intentions alone do not produce good government. Incentives matter.

That lesson is just as relevant today.

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