Plan Realigns Federal-State Incentives to Combat Fraud, Slashes Bureaucracy and Prioritizes Medicaid Fraud Enforcement to Make Healthcare More Affordable for Ohioans
COLUMBUS, OH — Today, Republican nominee for Ohio Governor Vivek Ramaswamy announced his plan to crack down on Medicaid waste, fraud and abuse while making healthcare more affordable for Ohioans. The proposal focuses on three core reforms: aligning federal and state incentives to combat fraud, simplifying Medicaid bureaucracy and making Medicaid fraud prosecution a top statewide enforcement priority. Savings generated would be returned to law-abiding Ohioans through lower healthcare costs.
Vivek was joined at a Columbus press conference by Ohio Senate President and lieutenant governor candidate Rob McColley, Speaker of the Ohio House of Representatives Matt Huffman, Ohio Auditor of State Keith Faber and Daily Wire reporter Luke Rosiak, whose recent investigative series examined alleged Medicaid fraud in Ohio.
“Fraudsters and corrupt providers are stealing resources away from vulnerable Ohioans and driving up healthcare costs for everyone else. As Governor, I will work with state and federal leaders to make fighting Medicaid fraud a top priority, strengthen enforcement, simplify the bureaucracy and return the savings to Ohioans through lower healthcare costs,” said Vivek.
Vivek’s plan begins by fixing the broken incentive structure that discourages states from aggressively pursuing Medicaid fraud. Although Ohio administers Medicaid, current federal rules mean the state keeps less than $0.35 of every $1 it saves by rooting out fraud. Vivek would seek approval from the federal Centers for Medicare & Medicaid Services (CMS) to initiate a time-bound Demonstration Project to reverse that split, allowing Ohio to retain at least $0.65 of every $1 saved through stronger fraud detection, investigation and prosecution. Building on Tennessee’s successful waiver model, which freed up $1.3 billion for healthcare priorities, Ohio could generate an estimated $4.7 billion in total taxpayer savings from a 10% reduction in FY 2027 Medicaid spending. That would include roughly $3.1 billion to help lower healthcare costs for law-abiding Ohioans through a variety of methods, including but not limited to co-pay assistance, reduced insurance premiums, and increased value of Health Savings Accounts.
Vivek would also simplify Ohio’s Medicaid bureaucracy to combat fraud. Approximately $47 billion in Medicaid funding is expected to flow through as many as 10 state entities by FY 2027, creating confusion for patients, providers and taxpayers, and leaving an opening for bad actors to exploit a broken system.
Finally, immediately upon taking office, Vivek will work with the Ohio Attorney General to make Medicaid fraud prosecution a top statewide enforcement priority. In partnership with the Ohio General Assembly, he will strengthen front-end safeguards to stop fraud before taxpayer dollars go out the door and ensure fraudsters are cut off before they can disappear with money meant for Ohioans in need.
Vivek added, “Ohio should lead the nation in building a Medicaid system that is accountable, enforceable and focused on the people it was created to serve. As your next governor, that is exactly what I will fight to deliver.”
Vivek has already begun discussions with key federal leaders, including CMS Administrator Dr. Mehmet Oz, and will continue advancing the framework for a potential collaboration that can take effect shortly after he is inaugurated as Ohio’s next governor in January 2027.
Tuesday’s policy announcement aligns with the release of the campaign’s latest ad, “Afford to Get Better,” which highlights Vivek’s commitment to making healthcare more affordable for Ohioans.
Learn more about Vivek’s plan to crush Medicaid fraud here.