THE AMERICAN SPECTATOR – For more than 30 years, Washington has known that Medicaid hemorrhages taxpayer dollars through fraud, waste, and abuse, including payments for people who are already dead.
On Dec. 23, 2025, the HHS Office of Inspector General released a nationwide audit estimating that Medicaid made $207.5 million in unallowable capitation payments to managed care organizations on behalf of deceased enrollees in just one year, from July 2021 through June 2022 — confirming what insiders have long understood.
The federal share alone totaled $138.6 million. These payments occurred because states failed to promptly disenroll recipients after death, a basic safeguard federal watchdogs have warned about for decades.
The Inspector General made clear that this was not a first-time failure. Audits dating back to 2016 had already identified nearly $289 million in similar improper payments, yet the same weaknesses persisted.
The fact that this report drew immediate national coverage reflects how little progress has been made despite years of warnings.
This was not a secret scandal. It was institutional indifference.
Using the federal government’s own data, the scale of the problem becomes clear. If Medicaid improperly paid providers and managed care organizations roughly 100 million dollars per year on behalf of recipients who were already deceased, a conservative projection based on the most recent audit, and if this narrow failure continued since the mid-1990s, the cumulative cost to taxpayers would be substantial.
Over 30 years, even applying a modest 3 percent annual compounding rate that is well below long-term Treasury yields, losses from this single category of improper payments would plausibly exceed five billion dollars.
This is not a reported total but an illustrative projection, and it highlights how quickly waste accumulates when basic controls are ignored year after year.
That estimate reflects only one sliver of the problem. It excludes the broader universe of Medicaid waste documented repeatedly by federal auditors …
