Shawn Fleetwood writes for the Federalist about a problem plaguing a neighboring state’s Medicaid program.
Elected Republicans may have declared war on leftists’ racist DEI ideology in state governments across the country. But that doesn’t mean the unelected bureaucracy isn’t fighting back.
That’s the main takeaway from a new report by the State Leadership Initiative (SLI), which documents how a pro-DEI organization known as the National Association of Medicaid Directors (NAMD) allied itself with the Peach State’s bureaucracy to alter “the entire trajectory of the Georgia Medicaid program by inserting California values into the bureaucratic process of Georgia, without a single elected official noticing.” Obtained by The Federalist, the new analysis underscores the danger of this unelected “shadow government” that “is incredibly effective at utilizing bureaucratic processes to govern.”
“The National Association of Medicaid Directors is an organization no one has ever heard of — but their members collectively oversee over $900 billion in government spending, the largest individual program of every state budget,” SLI Founder and President Noah Wall told The Federalist. “This organization has weaponized Medicaid by forcing woke policies into conservative states. No conservative state should subject their constituents to their extreme politics and underhanded way of weaponizing critical programs for their progressive ends.”
The SLI analysis begins by highlighting a March 2025 investigation by the Washington Free Beacon, which uncovered records showing how senior staffers at Georgia’s Department of Community Health (DCH) “hijacked” the state’s Medicaid bidding process for insurance providers to “insert a question related to transgender children.” “Insurers whose answers reflected left-wing policy priorities,” the outlet noted, “secured a piece of the multibillion-dollar contract … which is set to go into effect in mid-2026.”
As it turns out, that outcome appears to have been only made possible by the state bureaucracy’s under-the-radar alliance with NAMD — which has a history of touting leftist ideology.
