Republican lawmakers are lying about Medicaid fraud

House Republicans passed a budget bill on Feb. 25 that calls for $1.5 trillion in federal spending cuts, a feat that will be near-impossible to accomplish without deep cuts to Medicaid.

Nearly 20% of Americans get their health insurance through Medicaid and most voters oppose making any cuts to the program at all. Republicans have tried to preempt political blowback to their budget by claiming Medicaid cuts would focus on fraud and waste, not services.

“Medicaid is hugely problematic because it has a lot of fraud, waste, and abuse,” said House Speaker Mike Johnson (R-LA) on Feb. 25. “Everybody knows that. We all know it intuitively. Nobody here would disagree … The estimate is $50 billion a year in fraud alone in Medicaid. Those are precious taxpayer dollars. Everybody is committed to preserving Medicaid benefits for those who desperately need it, deserve it, and qualify for it. What we’re talking about is rooting out the fraud, waste, and abuse.”

Johnson’s $50 billion claim appears to come from Stewart Whitson, the senior director of the conservative Foundation for Government Accountability. On Feb. 12, Whitson gave testimony on alleged Medicaid fraud to the Subcommittee on Delivering on Government Efficiency, the congressional counterpart to Elon Musk’s DOGE.

Much of Whitson’s testimony, however, focused on improper payments, most of which are not fraudulent. Improper payments can be overpayments or underpayments disbursed by Medicaid. Many of these payments are the result of billing or paperwork errors.

When CNN’s Kaitlain Collins asked Rep. Mark Alford (R-MO) on Feb. 24 if he would vote to cut Medicaid, he made a similar claim as Johnson.

“I will vote for a bill that has savings for Medicaid, and I’ll tell you the difference,” Alford said. “There is waste, abuse, and fraud in Medicaid. We’re finding out through DOGE and the access to this data that there is waste, abuse, and fraud in just about every government program.”

It is not clear what resources DOGE has to investigate Medicaid fraud. Nearly 75% of Medicaid is administered by states, not the federal government, which is what DOGE is auditing.

Claims of rampant Medicaid fraud also contradict recent inspector general reports. 

Since 1997, the Justice Department and the Department of Health and Human Services (HHS) has compiled an annual report investigating Medicaid fraud. These reports consistently found that the bulk of fraud is committed by health care providers and contractors, not beneficiaries.

The report for fiscal year 2023 found that the Biden administration made significant gains in cracking down on Medicaid fraud. More than $3.4 billion in fraudulent payments was recovered, nearly doubling what was recovered in 2022.

On Jan. 24, President Donald Trump fired the inspector general in charge of compiling these reports. The stated reason for the firing was “changing priorities.”

House Republicans have openly discussed making other changes to Medicaid, including new work requirements for beneficiaries. The nonpartisan Congressional Budget Office estimates that work requirements for Medicaid would result in approximately 600,000 Americans losing their health insurance.

Trump had reportedly expressed wariness about Medicaid cuts, despite aggressively pursuing them in his first term. 

In 2017, Trump endorsed a repeal of the Affordable Care Act that would have cut Medicaid by $880 billion. In 2020, his administration tried to empower states to implement new work requirements for Medicaid. These efforts faced legal challenges and were ultimately reversed by the Biden administration.

Nine of the ten states that receive the most Medicaid funding supported Trump in the 2024 election.