Idaho Medicaid fraud enforcement a money loser. The real purpose is theater | Opinion
.jpg "Idaho Attorney General Raul Labrador, left, at a news conference dealing with the White House Fraud Task Force.")
At a May 26 joint press conference with Vice President JD Vance and other White House officials, Idaho Attorney General Raúl Labrador announced the results of his decision to join the White House Fraud Task Force.
“The Trump Administration is serious about fraud enforcement, and Idaho’s results prove what’s possible when the federal government works with states instead of against them,” Labrador said in a news release.
The results? Labrador’s office spent just under $1.5 million to prosecute Medicaid fraud, including five indictments and returning about $900,000 in funds.
That is to say, for every dollar we spent investigating Medicaid fraud, we recovered 61 cents.
It would be overly simplistic to view this as a pure 39% loss of taxpayer funds. There are independent benefits to finding and prosecuting fraud. To some degree, it likely prevents further fraud through deterrence; it can increase public confidence in the Medicaid program; and so on.
But enforcement resources are scarce and have alternative uses. There are clearly better ones.
And it’s not that there isn’t a lot of fraud out there; it’s common. Far more common and more consequential than Medicaid fraud is tax fraud, which tends to benefit the wealthy for obvious reasons.
The return on investment to rooting out this kind of fraud is far higher. A 2021 report by the Congressional Budget Office found that for every $1 spent on tax enforcement, about $7 is returned to the Treasury.
Put another way, you’d spend less than $100,000 on tax enforcement to make up the $573,000 taxpayers lost on tracking down Medicaid fraud this year in Idaho.
If Labrador really was concerned about protecting taxpayers from fraud first and foremost, this is one area he could focus on. But don’t hold your breath. This isn’t about taxpayers; it’s purely about politics, messaging and Labrador’s personal ambition. This isn’t about Idaho; it’s about Minnesota.
Vance announced this task force in January, jumping on reports of significant Medicaid fraud in Minnesota, which was especially politically useful because several prominent perpetrators were Somali immigrants, which fed into the virulently anti-immigrant sentiments that have fueled President Donald Trump’s base.
Soon, you had people showing up at any daycare run by someone with a name that didn’t sound like a white person’s.
It’s good that a few people defrauding Medicaid have been caught, but it doesn’t indicate a systemic issue with fraud in Idaho Medicaid or that immigrants and refugees are taking Idaho taxpayers for a ride. While it’s good that Labrador’s office caught a handful of cases of fraud, as is often the case, the political theater surrounding this affair is carefully crafted deception.
And it’s worth dispensing with another obvious misconception this announcement will give rise to: that there are a lot of undeserving people in Idaho getting Medicaid benefits.
Medicaid fraud is mostly not a matter of undeserving people getting on the rolls or people getting healthcare to which they aren’t entitled. It’s almost entirely unscrupulous medical providers engaged in various kinds of billing fraud — double billing, billing for procedures not performed or medicines not administered, etc.
As Georgetown Professor Andy Schneider noted, the last Office of the Inspector General report reviewing convictions by state Medicaid fraud control units found that beneficiaries represented only 2% of convictions and 0.1% of recovered funds. That’s not nothing, but it’s very close.
No numbers were available for Idaho, according to the AG’s Office.
And the total amount of fraud is small. For context, there was $4.1 billion in Medicaid spending in Idaho in fiscal year 2024, so Labrador’s $900,000 recovery represents 0.02% of total Medicaid spending.
Medicaid fraud is a priority purely because of politics, which is why Labrador traveled out of state to announce these numbers in conjunction with other Republican AGs at a staged news conference with Vance, Stephen Miller and other White House officials.
And the lie is far more pernicious and more harmful than a handful of fraud cases. Driven by nativist sentiment, the One Big Beautiful Bill will cut off Medicaid and SNAP access to refugees around the country in October, leaving innocent, vulnerable people fleeing persecution without food and medicine.
The real tragedy is that we have become a nation so heartless and cruel that we would allow that to happen.
Bryan Clark is an opinion writer for the Idaho Statesman.