“Medicaid Cuts” or Medicaid Reform?
What the Media Isn’t Telling You About the Real Threat to Healthcare
Hi friends,
Once again, the legacy (left) media tells part of the story. Some of you may remember Paul Harvey and ‘The Rest of the Story’ radio program.
Well, whenever you read or hear that conservatives or Republicans (some Republicans are conservative) have done something egregious, remember, there’s ‘the rest of the story’. Always look at both sides and make up your own mind.
🩺 “Medicaid Cuts” or Medicaid Reform?
What the Media Isn’t Telling You About the Real Threat to Healthcare
When Republicans propose “cutting” Medicaid, headlines practically write themselves:
“GOP Pushes Cuts to Healthcare for the Poor”
“Republicans Slash Safety Net for the Most Vulnerable”
“Medicaid Under Attack by Right-Wing Budget Hawks”
It sounds devastating—heartless, even. That’s exactly the point of the narrative.
But here’s what those headlines won’t tell you: the so-called “cuts” are not reductions in care for the needy. They’re attempts to stop billions of dollars in fraud, waste, and political favoritism—the kind that takes vital resources away from real patients and reroutes them to bureaucrats, private unions, and even international crime rings.
As Dr. Mehmet Oz, the new Administrator of the Centers for Medicare & Medicaid Services (CMS), put it bluntly:
“Fraud is the greatest existential threat to the most vulnerable Americans.”
And he’s right.
🧾 What the Facts Actually Show
A review of CMS findings and recent public statements reveals a staggering misuse of Medicaid and Medicare funds—often hidden under layers of policy complexity. Here’s a breakdown of what’s actually been discovered:
🔁 Double-Enrolled Patients Across State Lines
Over $1 billion in Medicare funds went to individuals enrolled in multiple states—a problem compounded by poor coordination between state systems.
Most people only live in one state. Yet without better data-sharing and eligibility tracking, the federal government has been paying twice (or more).
🧹 $200 Million on Housekeeping Instead of Healthcare
Medicaid does cover some non-medical services, such as in-home support for disabled individuals. But audits have flagged excessive or misclassified payments, including large contracts for housekeeping services far beyond what’s medically necessary.
These payments divert dollars from hospitals and frontline care.
🎓 $10 Million in Student Loan Payouts from Medicaid?
CMS investigators flagged suspicious transactions where Medicaid funds were funneled into student loan payments—a use completely outside the program’s legal bounds.
No transparency. No oversight. Just taxpayer money gone.
🍼 $11 Million for Childcare Linked to Labor Unions
According to Dr. Oz, Medicaid funds were used to cover childcare benefits for private labor unions.
Unions are private organizations—not Medicaid-eligible entities. This type of benefit is normally paid for by employers or negotiated in collective bargaining agreements, not pulled from a safety net meant for the poor.
🚫 $31 Million in Fraud Stopped Just Last Week
CMS’s newer fraud detection tools intercepted $31 million in fake or improper Medicaid spending in a single week.
This shows two things: 1) the fraud is ongoing and widespread, and 2) we can catch it if we’re serious about enforcement.
🌐 Foreign Criminal Networks Are Involved
Multiple federal agencies, including the DOJ and FBI, have confirmed that international fraud rings have exploited U.S. healthcare systems, using fake identities, ghost clinics, and billing scams to steal billions.
In many cases, these networks exploit lax verification processes in Medicaid, a program built on trust but woefully unprotected.
wiat for Heritage Action
🧍♀️ Who Loses When Fraud Wins?
For every dollar stolen through Medicaid fraud, a deserving patient is left without care, a family goes without help, or a hospital faces budget shortfalls. Here’s who really suffers when the system is exploited:
👵 Low-Income Seniors and the Disabled
Medicaid serves millions of elderly Americans who rely on it for nursing home care, wheelchairs, prescriptions, and in-home support. When funds are drained by fraud—like paying out for nonexistent patients or inflated service costs—these vulnerable seniors are the first to experience waitlists, denied claims, or underfunded clinics.
👩👧👦 Working-Class Families
Many working families earn too much to qualify for full benefits, but still need help covering children’s healthcare or long-term treatment for a chronic condition. When the program is bloated with ineligible recipients or siphoned off for special interests, honest families fall through the cracks.
🏥 Rural and Community Hospitals
Small providers rely heavily on Medicaid reimbursements. When Medicaid dollars are squandered elsewhere, these clinics face closures, layoffs, or reduced services. It’s no coincidence that rural hospitals are closing at record rates while fraudulent billing scams rake in millions.
The American Taxpayer
Medicaid spending topped $800 billion last year—making it one of the largest line items in the federal budget. When criminals abuse the system, or when politically connected groups get side deals, it’s you who foots the bill.
And every dollar spent keeping a ghost patient on the rolls or funding union childcare is a dollar not spent helping a child get insulin or a veteran receive rehab.
This isn’t theoretical. It’s a zero-sum game.
Fraud doesn’t just make the system inefficient—it undermines the very mission of Medicaid and Medicare.
So when leaders like Dr. Oz propose rooting out this abuse, and Congress drafts bills to tighten eligibility and remove shady funding practices, it’s not “cruel” or “callous.” It’s common sense. It’s stewardship. It’s protecting the people these programs were meant to serve.
Medicaid Reform - a look at some numbers
Reforming Medicaid is not about removing people from Medicaid, it’s about common sense changes that ensure we are serving the people who need it most and people get the care they deserve.
One challenge for Medicaid is that Obamacare created a new eligibility category: able-bodied, childless adults. To entice states to adopt this expansion, the federal government raised its share of how much cost it will cover to 90 percent. While conservatives would like to see Congress make the match rate for able-bodied, childless adults be the same as the standard match rate (typically 55-65%), it is not expected they will include this change in the reconciliation package.
However, Congress is expected to include implementing work requirements for able-bodied enrollees as a condition of receiving Medicaid benefits. While conservatives continue to advocate for reforming the match rate, this is an important step and would be an important reform.
The Congressional Budget Office estimates that implementing work requirements would lead to 8.3 million people dropping off Medicaid rolls. 3.4 million would drop off because they are simply unwilling to work – but are able to. There are 1.6 million enrolled in multiple states - currently committing fraud. And, there are also illegal aliens that this would help to remove from the rolls.
This approach provides a clear argument to make to the American people: people who are able to work, should work. Medicaid was designed to serve women and children in poverty – it was meant to be temporary. This helps the program refocus toward the populations it was created to serve, and helps people to find the dignity of work.
For a deeper dive into Medicaid, you can read Nina Schaefer’s analysis.
As always, do your own research; make up your own mind.
References to other sources do not necessarily reflect my opinions, and I make no claim to their veracity or completeness. I provide them for your consideration.
(AI may have been used in this article.)
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