COLUMBUS, Ohio (AP) — Vice President JD Vance 's decision to extend his fight against Medicaid fraud beyond Democratic states to his red home state of Ohio has set off a scramble among the state's Republicans — including his close ally Vivek Ramaswamy, the party's nominee for governor.
A day before Ramaswamy won the state's May 5 primary, Vance posted to X that he was directing the anti-fraud task force he leads for President Donald Trump to turn its
sights on the Buckeye State. The decision came the same day an investigation by the conservative Daily Wire revealed apparent rampant abuses within Ohio's Medicaid-funded home health program.
Within days, U.S. House Republicans created a new Task Force on Defending Constitutional Rights and Exposing Institutional Abuses. They declared the fraud allegations in Ohio their first target.
It was a notable pivot, given that many of Vance's highest-profile sanctions so far have been targeted at blue states, including Minnesota, California and Maine. He has sought to tamp down criticism that the anti-fraud effort is partisan — noting some Republican states, including Florida, have been among those cited — but also has specifically called out Democrats as the ones who are enabling Medicaid scammers.
Ramaswamy seized the political opportunity on Tuesday, as he declared the fight against Medicaid fraud his “absolute top priority.” His plan to reduce healthcare costs and “crush” Medicaid waste, fraud and abuse includes renegotiating Ohio's deal with the Centers for Medicare and Medicaid Services to improve the percentage it receives in fraud-fighting incentives and to streamline the program's bureaucracy.
Modeled after a waiver Tennessee negotiated during the first Trump administration, the new arrangement would save $3.1 billion that could be pumped back into healthcare savings, the campaign estimates.
A common theme at Ramaswamy's news conference was the past failings of the state's Department of Medicaid, overseen by Republican Gov. Mike DeWine for the past seven years. The criticism was leveled not only by Ramaswamy, but by sitting Republican officeholders who have held sway over Ohio's existing checks and balances of the program for years.
Asked to what extent the ruling GOP establishment that has controlled government for more than 15 years should be held accountable for failing to catch more Medicaid fraud, Ramaswamy said he wouldn't point fingers. “I'm not playing that game, OK?”
“I think we need a fresh approach, and what my candidacy represents is, I believe, a bottom-up movement and a demand for change, positive change in the state," he said. “A movement beyond the status quo that takes a lot of this for granted.”
Ramaswamy’s running mate, Ohio Senate President Rob McColley, held key decision-making power over the state budget that last year eliminated Ohio’s Joint Medicaid Oversight Committee, which was charged with watching over Medicaid, a joint federal-state healthcare program that covers more than a quarter of Ohio residents. The panel was investigating contracts with Gainwell, the nation’s largest processor of Medicaid claims, at the time.
State Rep. Jennifer Gross, a Republican who served on the committee, said Tuesday that the panel could have helped accomplish Vance’s and Ramaswamy’s fraud-fighting goals.
“I believe that if we had kept JMOC it always could have been something that we kept in place that could have morphed into a DOGE Ohio, an Ohio Medicaid DOGE,” she said.
The Trump administration has framed its own anti-fraud efforts as a way to protect taxpayers who are feeling squeezed by economic woes. Several state-level Republicans and candidates have followed their lead.
At times, though, those financial stressors have resulted from the federal government’s own actions. New work requirements in Medicaid passed by Congress, for example, are expected to strain hospitals around the country and result in millions of enrollees losing their health coverage.
DeWine has bristled amid the debate. Under a national spotlight shone by his own party, the former congressman, U.S. senator and state attorney general announced a new series of Medicaid fraud prevention initiatives on May 13 — including pausing new enrollments in the home health program cited by the Daily Wire — but not before defending the “nation-leading work” that Ohio was already doing in the field.
On Tuesday, his spokesman Dan Tierney defended the governor's record and the record of the state's $43 billion Medicaid program, which serves more than a quarter of all Ohioans.
“A general sentiment that Ohio was not working to combat or prosecute Medicaid fraud prior to the publication of the Daily Wire stories is just not true,” he said. “There may be people who were unaware of Medicaid fraud prior to that, but Mike DeWine was not one of them.”
Tierney noted that Ohio is consistently ranked among the top states in the nation for prosecuting Medicaid fraud, with 2,300 indictments, 2,200 convictions and $644 million recovered since 2011. He said DeWine broke records for Medicaid fraud convictions three times as Ohio attorney general and his successor, Republican Dave Yost, has broken those records twice since then.
Republican Ohio Auditor Keith Faber, a 2026 attorney general candidate, said Tuesday that the Medicaid fraud that Ramaswamy is highlighting was not a surprise to state officials. He said that his office brought numerous findings to DeWine's previous Medicaid director, Maureen Corcoran, who stepped down in September after more than six years.
Records obtained by The Associated Press through a public records request show that Corcoran was fighting the oversight committee shortly before it was disbanded over access to the fiscal experts who are critical to Ohio's budgeting process. Those inquiries ended when the committee was subsequently disbanded.
Democratic governor candidate Amy Acton's campaign accused Ramaswamy of rolling out “scam policies.”
“As governor, Dr. Amy Acton will prioritize rooting out Medicaid fraud, waste, and abuse while ensuring that Ohioans can access affordable, quality healthcare,” campaign spokeswoman Addie Bullock said in a statement. “Dr. Acton is fighting to lower healthcare costs, protect Medicaid and Medicare access, and end the rampant corruption in Ohio’s Statehouse that has allowed fraud, waste, and abuse for far too long.”
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Swenson reported from New York.
