Fraud Is Not the Biggest Source of Health-Care Waste

As Vice President JD Vance leads the charge against wasteful spending in federal health-care programs, his Task Force to Eliminate Fraud has racked up some impressive wins. It helped the Justice Department take down hundreds of providers accused of defrauding Medicare and Medicaid of billions of dollars and removed 760,000 allegedly fraudulent enrollees from subsidized Obamacare plans, which should save $2.2 billion.

Insofar as fraud can be uncovered, these actions are worthwhile. Yet claims of reining in spending through tighter enforcement are vastly overblown. True criminal conduct is a drop in the bucket of Medicare and Medicaid, which cost federal taxpayers a combined $2 trillion this year. Estimated improper payments in both programs amounted to just $94 billion in 2025, or less than 5 percent of total spending, and eliminating all of it would be practically impossible.

About the Author

John R. Puri

John R. Puri is the Thomas L. Rhodes Fellow at National Review.

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As Vice President JD Vance leads the charge against wasteful spending in federal health-care programs, his Task Force to Eliminate Fraud has racked up some impressive wins. It helped the Justice Department take down hundreds of providers accused of defrauding Medicare and Medicaid of billions of dollars and removed 760,000 allegedly fraudulent enrollees from subsidized Obamacare plans, which should save $2.2 billion.

Insofar as fraud can be uncovered, these actions are worthwhile. Yet claims of reining in spending through tighter enforcement are vastly overblown. True criminal conduct is a drop in the bucket of Medicare and Medicaid, which cost federal taxpayers a combined $2 trillion this year. Estimated improper payments in both programs amounted to just $94 billion in 2025, or less than 5 percent of total spending, and eliminating all of it would be practically impossible.