State Medicaid programs are in the midst of removing millions of people from their rolls. According to new data , more than 1.5 million in 27 states have found themselves jettisoned from the program since the end of March. Many Democrats have alleged that this Medicaid purge is unfair and unjust. In reality, it's essential to the program's long-term viability.

Let's start with the reason people are losing their Medicaid coverage. They haven't shown that they're eligible, as the law requires. This is neither arbitrary nor capricious, and it isn't happening out of the blue. As part of last year's federal budget deal, states gained the ability to resume verifying whether Medicaid enrollees were actually eligible for the program starting this past April.

They hadn't been able to do so for the previous three years. During the COVID-19 public health emergency, Congress essentially barred states from kicking people off Medicaid, even if they were ineligible. It did so by offering states significant amounts of federal cash to keep people continuously enrolled. Over a three-year period, the ranks of those covered by Medicaid grew from 64 million to 85 million. But the public health emergency is over. It makes no sense for taxpayers to continue covering the cost of Medicaid for people who are not eligible for the program under its own terms.

Medicaid is hurtling toward the edge of a financial cliff. In 2021 , Medicaid spending reached $734 billion. That's equivalent to one of every six dollars the country spends on healthcare. The Centers for Medicare and Medicaid Services project that Medicaid spending will exceed $1 trillion within the next five years.

That's simply not sustainable. But it's the inevitable result of COVID's inflation of enrollment. Just before states gained the authority to audit their Medicaid rolls, the program covered about 100 million people, according to estimates from the Foundation for Government Accountability. That's nearly one in three Americans — well beyond the mission of Medicaid when it was created in 1965 to insure the poor and the disabled. Taking those who are ineligible off the rolls is hardly unreasonable. On the contrary: By cutting costs and putting Medicaid on a firmer financial footing, it can better serve those who are eligible.

Besides, it's absurd to inflate the welfare rolls at a time when employers can't find enough workers. There are currently about 10 million positions open nationwide — almost two jobs for each unemployed job-seeker. Many who are ineligible for Medicaid can and should be securing employer-based health benefits instead. Others may qualify for subsidized coverage through an Obamacare exchange.

The best way to preserve Medicaid — and to help those it's meant to help — is to ensure that the people on the program's rolls are qualified to be there. The resumption of redetermination enables states to do just that.

Sally C. Pipes is president, CEO, and Thomas W. Smith fellow in Health Care Policy at the Pacific Research Institute. Her latest book is False Premise, False Promise: The Disastrous Reality of Medicare for All (Encounter 2020). Follow her on Twitter @sallypipes.