A coronavirus relief bill signed by President Trump on March 18 included a 6.2% increase in states’ Medicaid matching rates for the duration of the pandemic. But the additional dollars came with a big catch: States can terminate Medicaid enrollment during the public health emergency only if “the individual requests a voluntary termination of eligibility” or moves out of state. No increase in income or assets, no matter how great, permits a state to disenroll someone from Medicaid.

The CBO report quantified the effects of these policies. The budget office believes the pandemic will increase Medicaid enrollment by about nine million in 2021, and spending by $86 billion, next year compared to its March pre-Covid projections. The CBO estimates that “about half of the projected increase in enrollment . . . results from the new requirement that states allow people to remain enrolled in Medicaid longer,” meaning approximately 4.5 million otherwise ineligible people will remain on the rolls.

To see how these policies are having an impact, consider Louisiana’s Medicaid expansion. Early last year, following an audit that showed people earning over $145,000 a year remained on Medicaid, the state began checking income eligibility on a quarterly basis. The audits led to the removal of 30,000 from Medicaid—including at least 1,672 with income of over $100,000—saving taxpayers some $400 million.

But since Congress imposed the maintenance of effort provisions this spring, enrollment in Louisiana’s Medicaid expansion has exploded. From March through September, enrollment surged 16.5%, or more than 78,000, to reach all-time highs. The CBO’s assumption that the maintenance-of-effort requirements explain half of the enrollment increase suggests approximately 40,000 Louisianans have remained on expanded Medicaid after becoming ineligible—more than the state removed from the rolls last year.

While some might argue this explosion in Medicaid enrollment is a pandemic-driven anomaly, Democrats want to make it permanent. In June Speaker Nancy Pelosi pushed through an ObamaCare “enhancement” bill that would require states to keep individuals continuously enrolled in Medicaid for 12 months before checking eligibility, at a cost to taxpayers of nearly $205 billion over 10 years.

With federal debt soaring, neither states nor Washington can afford to keep ineligible individuals on the Medicaid rolls. Democrats are showing the fiscally irresponsible nature of their drive to expand the welfare state.

This post was originally published at The Wall Street Journal.