(The Center Square) – It’s not just lower-income people or those with disabilities using Medicaid in the United States.
A new investigation led by the Patient First Coalition found that tens of thousands of wealthy people remain enrolled in Medicaid, the taxpayer-funded health insurance program meant for low-income and disabled Americans.
It’s an issue happening nationwide, the report said, though Ohio, Arizona, and South Carolina represent some of the more egregious examples. The issue is costing American taxpayers over $200 billion annually, the Patient First Coalition says.
Shannon Burns, a senior advisor with the group, told The Center Square in a phone interview that, “What we’re looking at is not reform. This is just simply asking the federal government to enforce the law.”
Burns is referring to the Medicaid Extenders Act of 2019. The bipartisan law requires states to verify people’s Medicaid eligibility.
In Ohio, the Department of Medicaid checked the assets of a sample of ABD (Aged, blind, and disabled) enrollees. However, it found that over 10,000 millionaires were improperly enrolled in the program, according to the Patient First Coalition. The same is true for around 8,000 people in South Carolina and over 20,000 in Arizona.
That’s the case even though Ohio and Arizona have Medicaid asset limits of $2,000. A Medicaid asset limit is the maximum value of assets an individual can own to qualify for Medicaid.
Additionally, Ohio only had its contractor, LexisNexis Risk Solutions, examine 56% of the files, according to Patient First Coalition. Only a quarter of enrollees were checked in Arizona and South Carolina — and only for liquid assets, as was the case in Ohio.
“This contractor only looked for the presence of liquid assets in U.S. bank accounts with routing numbers,” Burns said. “They didn’t look at second homes, luxury cars, or even stocks.”
So far, no members of Congress have launched a national oversight investigation into the matter. Yet, the Patient First Coalition is calling for one, and Burns said just one inquiry could expose a massive scandal.
“The #MedicaidMillionaires scandal clearly demonstrates an immediate need for congressional intervention,” Burns said in a statement. “The extensive systemic fraud identified in South Carolina and Ohio represents a unique opportunity to recover over $200 billion annually. Congress must act swiftly to eliminate this widespread abuse by throwing millionaires off Medicaid, ensuring Medicaid serves only those who truly need assistance.”
Burns added that some state Medicaid officials claimed the Biden administration discouraged disenrollment, keeping people on the rolls even if they didn’t qualify for Medicaid.
“This isn’t waste, fraud, and abuse,” Burns said. “This is a system that’s designed to steal the money from those that actually need it.”
The Patient First Coalition is urging Congress to take action.
It wants a full 50-state audit of Medicaid eligibility vendors, enforcement of the 2019 Medicaid Extenders Act, and hearings on the scope of the fraud. They’re also calling on the Congressional Budget Office to update its scoring to reflect the billions in potential savings so that recovered funds can be redirected to support Trump’s proposed “Big Beautiful Bill.”
