We’ve explained how Washington’s all-you-can-spend Medicaid buffet reduces the incentive for states to police waste and fraud. Now arrives more evidence.

[audio] Republicans Brace for a Blue Wave / The Supreme Court’s Case on Religious Schools, Again On Friday the Justice Department announced charges against several more defendants in Minnesota for allegedly defrauding the food-stamp and Medicaid programs, including for autism therapy, home support, night supervision and personal care. DOJ officials dubbed Minnesota the “epicenter for fraud,” but the regrettable reality is that Medicaid grift is widespread.

Rhode Island Attorney General Peter Neronha recently charged seven defendants for a scheme to bilk the state’s Medicaid Community Health Worker program. “As the federal government continues to restrict Medicaid funding to the states, we must be even more vigilant in protecting these life-saving funds,” the Democratic AG said.

Translation: The GOP’s Medicaid reforms and the Trump Administration’s threat to withhold federal funds if states don’t police providers is impelling states to be more diligent in policing fraud, at long last.

The Rhode Island indictment illustrates how many state Medicaid programs all but invite fraud in order to draw more federal funds. Rhode Island established the Community Health Worker program in 2022 to help “Medicaid recipients navigate the healthcare system,” according to the state. No special skills required for the job.

Workers merely must have “similar cultural knowledge, practices, and beliefs” as well as “life experiences” as the Medicaid beneficiaries they are assisting. Their job is to ensure that beneficiaries have “timely access to healthcare and social services,” the state says. In other words, sign beneficiaries up for more government welfare.

They are also supposed to “advocate and work for policy changes to increase equity.”In other words, the state has been using Medicaid funds to pay left-wing activists. This program was essentially built to be bilked, so it’s amusing that the state is now complaining that this is what’s happening.

The indictment alleges that individuals connected to U’Nique Diversity Innovations, a community health worker outfit, submitted fraudulent claims for services not provided as well as “purportedly provided to family members and while beneficiaries were incarcerated.”Two defendants were also charged for failing to report income from the sham outfit while receiving food stamps.

You have to marvel at the ease with which they managed to bilk multiple welfare programs. Rhode Island and many other states have blown open the door to fraud by letting Medicaid pay for non-medical benefits, such as transportation and housing. We recently told you about the rampant grift in New York’s Medicaid “social adult day care” program.

New York has finally begun to target fraudsters after the Trump team threatened to freeze federal Medicaid funds. States also face more financial pressure to stop fraud and abuse since Republicans last summer curbed a provider tax scheme that they use to launder more federal Medicaid funds. What do you know?

Medicaid spending has finally begun to slow after a meteoric increase during the Biden years. Federal and state Medicaid spending was up 2.2% in September from a year earlier, compared to a 12.7% increase in the prior year. Meantime, food-stamp enrollment declined by 5.5 million between July 2025 and July 2026.

That’s largely because the GOP tax bill toughened work requirements and put states with high improper payment rates on the hook for a share of their benefits. Incentives matter, Q.E.D.