For decades, politicians have used isolated stories about public assistance fraud to divide people and build support for cuts that ultimately hurt working families while benefiting the wealthy and well-connected. That strategy is back again in Maine.
Fraud should always be investigated and stopped. But Mainers deserve facts, not political fearmongering designed to undermine health care for hundreds of thousands of people.
Here are seven things Mainers should know about political attacks on MaineCare, Maine’s Medicaid program.
1. This is part of a long-running political strategy, not a good-faith effort to improve government
Attacks on Medicaid and other public programs often follow a familiar script: amplify a handful of sensational stories, suggest the entire system is corrupt, use the outrage to justify cuts to public services. We’ve seen this playbook before. It’s been used for decades to divide working people from one another while shifting attention away from policies that concentrate wealth and power at the top.
The goal is not simply accountability. If it were, the conversation would focus on improving oversight systems and ensuring proper enforcement. Instead, the broader push is aimed at undermining confidence in public programs themselves while reducing their capacity to work as intended.
2. Fraud is a real concern and Maine already has systems in place to detect and address it
MaineCare is a large and heavily monitored program serving nearly 400,000 Mainers through thousands of health care providers across the state. Multiple state and federal agencies oversee the program and investigate wrongdoing when it occurs.
Those include:
- DHHS audit and compliance divisions
- MaineCare’s Program Integrity Unit
- Fraud investigators within the Office for Family Independence
- The Maine Attorney General’s Healthcare Crimes Unit
- Federal oversight by the Centers for Medicare & Medicaid Services (CMS)
The existence of investigations and recovery efforts is evidence these systems are working, not evidence the entire program is broken.
3. Maine’s record on payment accuracy is stronger than the national average
The rhetoric surrounding MaineCare would lead many people to believe Maine has an unusually severe fraud problem. The data says otherwise.
In the most recent federal review, Maine’s Medicaid payment error rate was 2.4% which is meaningfully lower than the national average of 3.2%. And even that figure does not mean fraud. Federal reviewers identified only a very small share of payments — about 0.1% of total program spending — as confirmed monetary losses where payments were definitively determined to be incorrect. That is a far cry from the sweeping claims now dominating headlines and political talking points.
4. “Improper payments” are not the same thing as fraud
Much of the current rhetoric relies on conflating “improper payments” with criminal fraud. Those are not the same thing.
An improper payment can include missing or incomplete paperwork, documentation submitted incorrectly, administrative or billing mistakes, or payments that require additional review.
Nationally, most Medicaid improper payments are tied to documentation issues, not intentional fraud. Political actors are using technical audit findings to create the impression of widespread criminal abuse where the evidence often does not support that conclusion.
5. Large dollar figures can sound alarming without context
MaineCare is a multi-billion-dollar program that processes millions of claims. In a system that large, even relatively small error rates can produce headlines involving millions of dollars. But context matters. For example, one widely publicized case involving approximately $1.1 million in allegedly fraudulent payments represented only a tiny fraction of overall MaineCare spending during that period.
Any misuse of taxpayer dollars should be addressed. But isolated cases should not be used to discredit an entire health care system that provides essential care to children, older Mainers, people with disabilities, and working families across the state.
6. Some of these attacks rely on dangerous scapegoating and insinuation
Mainers should be cautious when politicians and media figures selectively spotlight providers connected to immigrant communities while implying broader criminality without evidence.
There is a troubling pattern nationally of using allegations involving immigrant or Somali American communities to generate political outrage around public assistance programs. This kind of rhetoric divides communities, fuels suspicion, and distracts from the actual work of ensuring accountability and effective oversight. It also is in stark contrast to an equally troubling pattern of politically connected individuals responsible for far larger fraud schemes receiving far less condemnation, and in some cases, even clemency.
For example:
- Florida Senator Rick Scott previously led a hospital company that paid what was then a record $1.7 billion settlement over Medicare and Medicaid fraud allegations.
- President Donald Trump granted clemency to several individuals convicted in major Medicare and Medicaid fraud schemes involving hundreds of millions, and in some cases more than a billion, dollars in fraudulent activity.
- Maine Republican Representative Bob Nutting’s over-billing of Medicaid by $1.6 million and failure to repay the money did not result in outrage from his party. In fact, the Republican majority in 2010 elected him Speaker of the Maine House and today he still serves as ranking member of the Criminal Justice and Public Safety Committee for House Republicans as well as a member on the House Ethics Committee.
7. The real danger is using these claims to justify cuts that hurt everyone
The biggest threat facing MaineCare is not isolated fraud cases. It is the effort to use those cases to weaken public support for health care programs that hundreds of thousands of Mainers rely on.
When politicians exaggerate fraud to justify cuts, the consequences are real: children lose health coverage, rural hospitals face deeper financial strain, seniors lose support services, and working families struggle to access care.
Meanwhile, many of the same political leaders pushing these narratives continue to support tax policies that overwhelmingly benefit wealthy households and corporations. They do this while actively thwarting efforts to go where the real money is. For example, the Trump administration laid off thousands of IRS employees responsible for going after tax cheats and making sure the wealthy and large corporations pay what they owe. We already have an annual tax gap — the difference between what people owe and what they pay — of close to $700 billion per year. Continued staffing reductions and forgone enforcement by the IRS are projected to cost hundreds of billions more in lost revenue over the next 10 years. This represents more than enough money to fund universal child care, significantly increase health care access and food assistance, and make major investments in infrastructure and affordable housing.
Mainers deserve accountability and responsible stewardship of public dollars. And they also deserve honesty and an end to divide-and-distract politics designed to undermine programs that help ordinary people thrive.