Vice President J.D. Vance's effort to clean up waste in Medicaid began in earnest last month, with the first meeting of the administration's Task Force to Eliminate Fraud.
Judging from a new federal report, he's got his work cut out for him.
The study, issued last month by the Office of Inspector General at the U.S. Department of Health and Human Services (HHS), found that Medicaid fraud convictions increased in 2025, as did the number of fraud cases opened.
The size and scope of Medicaid's fraud problem is hardly news.
Finally, a presidential administration appears willing to do something about it.
Medicaid has wasted staggering amounts of taxpayer money on improper payments in recent years — nearly $543 billion between 2015 and 2024, according to the federal government's own data.
But those numbers almost certainly understate the extent of the problem. A more thorough analysis by the Paragon Health Institute estimates that improper payments totaled almost $1.1 trillion over that time.
The OIG report suggests that the administration has already gotten more aggressive about rooting out fraud in Medicaid. For starters, the number of fraud convictions has ticked upward lately, from 817 in 2024 to 856 last year.
The amount of money the nation's Medicaid Fraud Control Units have been able to recover also increased last year, to $1.3 billion — up from $961 million in 2024.
These victories are worth celebrating.
But they represent only modest progress toward ridding the program of the kind of rampant abuse that has proliferated in Medicaid.
For example, President Biden's efforts to weaken oversight and enforcement of the entitlement's eligibility rules resulted in a massive increase in the number of Medicaid enrollees who didn't quality for the program under the law.
According to the Congressional Budget Office, nearly 13 million beneficiaries fit this description in 2022.
Vice President Vance's new Task Force seems poised to tackle this challenge. That group was first announced during President Donald Trump's State of the Union Address, in February. And it was officially established through executive order just weeks later.
"This is not just the theft of the American people's money," Vice President Vance said. "It is also the theft of critical services that the American people rely on."
What's been missing, according to the vice president, is a "whole-government approach" to the problem.
Democrats have condemned these efforts — as well as related reforms aimed at targeting Medicaid resources towards those who need them most.
This is most apparent in the progressive campaign against the Medicaid work requirements established by last year's budget reconciliation law.
Under this new policy, all able-bodied, working-age Americans who wish to enroll in Medicaid must spend a minimum of 80 hours a month working, training, or volunteering in order to qualify for benefits beginning in 2027.
Much like the fraud crackdown, these requirements represent a commonsense attempt to rein in a program that has strayed far from its original purpose of caring for the disabled and destitute.
Today, Medicaid covers more than one in five Americans — many of whom are perfectly capable of working and providing for themselves.
The Urban Institute estimates that between 3 million and 7 million Medicaid enrollees might lose access to the program as a result of this reform. That's a relatively small reduction for a program that currently covers more than 68 million Americans.
Further, Medicaid spending is projected to exceed $1 trillion this year — and $2 trillion by 2032. Taxpayer resources are not limitless. It makes sense to preserve the program for those for whom it was established 60 years ago.
The first step in that process is to ensure that no more taxpayer money is wasted paying for coverage for people who don't belong in the program.
Sally C. Pipes is President, CEO, and Thomas W. Smith Fellow in Healthcare Policy at the Pacific Research Institute. Her latest book is "The World's Medicine Chest: How America Achieved Pharmaceutical Supremacy — and How to Keep It." Follow her on X @sallypipes. Read more Sally Pipes Insider articles — Click Here Now.