Right-wing media figures have spent weeks manufacturing a panic about supposedly epidemic levels of healthcare fraud in Ohio in what appears to be a pretext to slash a crucial Medicaid program.

On June 4, the Trump administration announced nine fraud indictments in Ohio, most of which had to do with healthcare spending. The Columbus Dispatch reports that the cases include $30 million in alleged Medicaid fraud and that they follow reports from conservative website The Daily Wire that “ignited a firestorm at the Ohio Statehouse.”  

Beginning in early May, The Daily Wire published several reports purporting to expose fraud in a Medicaid service called Home and Community-Based Services, or HCBS. The author, Luke Rosiak, promoted the stories across a range of right-wing media programs, including several produced by The Daily Wire, and recently testified about the issue before the House Oversight Committee. 

Rosiak’s approach echoed that of right-wing streamer Nick Shirley, whose misleading viral videos spurred investigations into Minnesota daycare centers late last year. Minnesota and Ohio have the largest and second-largest Somali populations in the U.S., respectively, and much of Rosiak’s commentary on his articles includes anti-Somali bigotry.  By Rosiak’s own admission, much of the supposedly abundant evidence of fraud he found wouldn’t hold up in a court of law. “Proving fraud to the standard that's required in court is so hard,” Rosiak said in one appearance. His preferred solution is to abandon the established process for dealing with Medicaid fraud and scrap HCBS altogether.    

Established in 1981, the Medicaid home health care program allows the elderly and people with disabilities to live at home, rather than in a facility or institution, by compensating those who provide long-term care for them, including family members. The nonprofit KFF, which focuses on healthcare policy, estimates that over 5 million people use the program, which “generally requires individuals to demonstrate that they need an institutional level of care” such as assistance with “bathing, dressing, eating, toileting, continence, and transferring between bed and other settings” — known as personal care services. 

In addition to personal care, KFF explained that the program offers a variety of services, “including adult day care, supported employment, round-the-clock care, services to support unpaid family or friends who are caregivers, home-delivered meals, and non-medical transportation.”

Ohioans with disabilities have been harshly critical of the rhetoric coming from the right-wing media campaign and of the subsequent political response from the Ohio state legislature. In a joint statement from Disability Rights Ohio and other groups, advocates warned about the “misinformation being spread in this latest attack” on the home healthcare program and said that “comprehensive data hasn’t been shown to support the allegations of ‘rampant fraud’ in the Medicaid system.”

Other conservative media figures have embraced the fraud investigations, which Vice President JD Vance, an Ohioan, is overseeing as part of a White House task force.

On June 5, the hosts of Fox & Friends discussed Vance’s so-called anti-fraud campaign. 

“What I love about it is it's not just in blue states,” said Brian Kilmeade. “He is over in Ohio.”

“And the president thinks we're finding so much. He goes, I might be able to balance the budget on the money that we can get back from all the fraudulent activity,” Kilmeade added.

Co-host Lawrence Jones argued the investigations were launched to reclaim money that was meant “to help American people.” 

“Look at the money and the damage being done to Americans because they have decided they were gonna take money that should have been for other programs to help American people — but they defrauded the government,” Jones said.

Yet Rosiak’s media appearances strongly suggest that the goal is not to strengthen the home healthcare program, but to provide political cover to cut its funding or even dismantle it by pitting Somali communities against supposedly more deserving native-born citizens.

One of Rosiak’s central claims is that the program pays relatives to “hang out” with their family members, which he says they should be doing anyway. The joint statement from advocates for people with disabilities highlighted this refrain and said that “such accusations are dangerous, grotesque, and extremely troubling,” and “highlight a fundamental misunderstanding about how home healthcare actually works.”

In an interview on Pizzagate conspiracy theory promoter Jack Posobiec’s right-wing podcast on May 4, Rosiak set a template he would return to frequently.

“That is what we're seeing Somalis in particular mastering, is the art of exploiting federal programs at scale and taking programs that were based on trust and good faith, and then just setting the country on the course for bankruptcy by just draining them and insisting on getting paid for doing things that any human being — any decent human being — would do for free,” Rosiak said.

He later explained that enforcement isn’t enough; his prescription is the elimination of the program.

“It poses all sorts of enforcement nightmares that I think itself would create an entire bureaucracy to police, so I say just get rid of this butler, what I call the butler code on Medicaid, which is personal services,” Rosiak said. “I think maybe you can have nice things or you can have mass immigration from low-trust societies, but what Minnesota and Ohio have found is you can't have both.”

Posobiec then expounded on the distinction between the deserving and undeserving recipients. “Unfortunately, what it does is it takes money that was meant for working-class folks like Ohioans who are there in the Rust Belt, who are good people, who are people who actually deserve it,” he said. “And it's handing it over to people who weren't supposed to be in this country in the first place.”

The same day, Rosiak told his Daily Wire colleague Michael Knowles that he believes the program should be shuttered.

“The easiest thing that the Trump administration can do here and that JD Vance can do in his own state is terminate the home healthcare waivers,” Rosiak said. “And it's kind of unfortunate that maybe the real granny that might want somebody to make her a bowl of soup once a day, that maybe she may not be able to get that taxpayer funded anymore. But I think this is unfortunately the cost of mass immigration.” 

Rosiak wasn’t done for the day. In an interview with MAGA influencer Benny Johnson, Rosiak repeated his diagnosis of the home healthcare program.

“I’m kind of aggressive here on this — I’ve kind of been redpilled after seeing it in person,” he said. “I think you’ve got to shut down the program because it’s whack-a-mole.” 

“First of all, it’s hard to prove,” Rosiak continued. “You can kind of see the massive, telltale signs of fraud when you go there, but being able to prove it in court is a long and difficult process when they’re giving services behind closed doors in their own house.”

“So my main thing is we can’t have programs where fraud is this difficult to prove when it occurs — you just have to get rid of the programs,” he added. “Maybe this is a choice we made when we decided to bring in immigrants from low-trust societies. Maybe we would’ve been able to have nice things and now we don’t, but I think they have to take away the waivers, for personal services, and possibly all home healthcare aides. … If somebody really needs to go to a nursing home, fine.” 

Johnson was immediately on board, replying, “You have a zero-trust society by proxy now — so we’ve brought that cancer in on ourselves.”

The next day Rosiak appeared on the podcast of Ben Shapiro, founding editor-in-chief of The Daily Wire, where Rosiak said it was time to “rescind these waivers” and “say no more personal services, no more butlers for Somalis.” 

Rosiak argued that because what he examined might not be prosecutable as fraud, the solution is to end the service entirely.

“I think we can no longer afford to have programs where proving fraud to the standard that's required in court is so hard,” Rosiak said, adding: “We may have to look at a policy solution rather than just fraud enforcement and just eliminating some of these programs.”

The stakes here couldn’t be higher. Already, Ohio Gov. Mike DeWine, a Republican, and the Ohio’s Medicaid department are “suspending Medicaid payments to 49 home health care providers that exhibited red flags for potential waste, fraud or abuse,” according to The Columbus Dispatch. 

KFF said the likely outcome is a shift from freezing funds when fraud has been identified, typically after an audit, to halting payments simply “when fraud is suspected.”

“This approach differs from prior approaches because, if implemented, it could have more immediate consequences, place a much larger share of federal spending at risk (including spending that pays for services uninvolved in fraud), and proactively shift the burden of proof to states to obtain federal funds,” KFF wrote. 

When Minnesota suddenly stopped payments to prevent alleged fraud, home healthcare providers “said the delay caught them by surprise and interrupted payrolls, leaving older and disabled Minnesotans without care,” according to Minnesota Reformer.