House Republicans introduced 14 bills this week aimed at tightening controls on Medicaid and other federally subsidized healthcare programs after a House Energy & Commerce Committee report warned that fraud and abuse are draining hundreds of billions of taxpayer dollars every year.
The report, released Tuesday, cites a 2024 Government Accountability Office estimate that $233 billion to $521 billion in taxpayer money across federal programs is lost to fraud annually. No specific estimate exists for Medicare and Medicaid fraud alone, but federal healthcare programs made up 24% of federal spending in 2024, according to the Center on Budget Policy and Priorities.
The committee’s report said Medicaid in particular has structural vulnerabilities that make it an easy target, prompting the new legislative push to close loopholes, cut bureaucracy, and give states more tools and incentives to recover lost money and pursue fraudsters.
“Taxpayers that fund benefit programs with federal and state taxpayer dollars are cheated by fraud, inflating healthcare costs that are passed along to everyone,” the report states. “Every dollar stolen from federal health care programs is a dollar that is not spent on high quality healthcare for those that need it most.”
House Energy & Commerce Committee Chairman Brett Guthrie, R-Ky., told Fox News Digital that the scale of the problem grew under the previous administration. “The amount of fraud that the Biden-Harris Administration allowed to go unchecked in government health programs is unacceptable. Every dollar stolen by fraudsters or wasted on improper payments is a dollar that cannot be used to support families in need who rely on these programs,” Guthrie said.
What the bills would do
The package falls into three broad categories: bills meant to improve detection of fraud in state and federal programs, bills meant to strengthen enforcement of existing anti-fraud rules, and bills meant to hold states accountable when fraud is allowed to persist.
- A bill led by Republican Study Committee Chairman August Pfluger, R-Texas, would require every state to designate a single official responsible for internal financial controls over its Medicaid program.
- A bill from Rep. Mike Rulli, R-Ohio, would require states to report annually to the federal government on Medicaid fraud vulnerabilities and their plans to address them.
- Legislation from Rep. Nick Langworthy, R-N.Y., would require states to check whether a Medicaid applicant had already been removed from another taxpayer-funded healthcare program before enrolling them.
Costs rising fastest in big states
The report found Medicaid spending now averages 30.7% of state budgets nationwide and has grown sharply in recent years. It singled out New York and California as states facing especially steep cost increases.
California’s Medi-Cal program is projected to grow from $83 billion a year in 2014 to $219.7 billion by 2027, the report said. New York is projected to spend $124 billion on Medicaid from all funding sources in 2027, an 11% increase.
How the fraud happens
The report attributes much of the vulnerability to the size and complexity of federal healthcare programs, combined with a traditional
