Medicaid fraud is rampant in America, as evidenced by recent headlines out of Minnesota and other states. The Trump administration is making a concerted effort to finally address this problem that has been decades in the making and is costing the country billions of dollars a year. The Justice Department is pursuing fraud cases in multiple states, and Vice President JD Vance is leading a new White House task force focused on rooting out government fraud. Congress has taken action too, with last year's Big, Beautiful Bill including a provision requiring able-bodied adults on Medicaid to either work or volunteer, something supported by more than 80% of Americans.
While all of these moves are a step in the right direction, government reform advocates want to see a more proactive approach to preventing fraud before it happens. Two of those advocates, Chris Medrano and Brian Blase of the Paragon Health Institute, are calling for stronger enforcement of new Medicaid rules. They note that the Biden administration loosened access to Obamacare and Medicaid by allowing people to self-report their income, job, and even medical status. This has led to massive improper enrollment in Obamacare and access to Medicaid by those who should not qualify.
Medrano, the co-author of the report, tells KTRH this problem has been growing for years because the current system incentivizes everyone to look the other way as long as people are signing up and the money is flowing to all stakeholders involved. "It's long overdue to actually enforce these requirements," he says. "Because a lot of the industry players have previously been saying we don't want to disrupt the status quo, we actually like that we're making more money off of Medicaid and off of these vulnerable populations."
What Medrano and his fellow advocates want to see is more teeth in the enforcement of Medicaid work requirements, meaning documented verification of income, job status, and medical status for all those who are claiming benefits....as opposed to the 'honor system' that has been in place. "We can continue to go down the previous path, or we can try to enforce, carefully and meticulously, a lot of these requirements," he says. "The solution is real verification...require a doctor's note, require the word of a medical professional."
"We need to see some receipts," he continues. "I think the taxpayers deserve that respect."