Corruption is a curse that no country or nation seems able to fully shake off. It is no surprise, then, that corruption can still be encountered within the Medicaid system. Reddit user Ok-Seaworthiness2288, a Montana citizen, decided to share their firsthand experience with Medicaid fraud after years of working closely with the program. They explained that they served as a Medicaid Access Specialist in a Montana hospital and later worked for the state’s Office of Public Assistance. From both roles, they witnessed the program’s life-saving impact on neighbors who could not afford care, as well as the strict safeguards in place to protect it from abuse. “And yes, I saw fraud. Oh boy, did I see fraud,” the Montana citizen said.
One case involved a fugitive attempting to use someone else’s Social Security number to dodge outstanding warrants. What she didn’t know was that every Medicaid application is cross-checked with Social Security records. She was denied almost instantly, and no taxpayer dollars were spent on her care until she returned to prison a few weeks later.
Another example concerned an elderly woman who tried to conceal the fact that she was married, owned property, and possessed the means to live comfortably. She did not realize that the IRS, the disability office, the OPA, and even the banks all share information. Her false claims quickly unraveled, and no public funds went toward her Medicare premiums.
Then there was the weekly scenario, a man claiming he had not worked in years and could not afford medical care. Upon review, steady income was found in his work history for every quarter. He too was denied Medicaid. In some cases, these same individuals would later return, this time telling the truth, often in far worse health and having lost homes, cars, or businesses before finally qualifying for help.
Between the falsehoods and the failed fraud attempts, Ok-Seaworthiness2288 saw thousands of Montanans who truly needed Medicaid. These included sick individuals, parents unable to get their children treated, and elderly neighbors depending on the program to cover Medicare premiums, nursing home costs, or caregivers.
The statistics were sobering, with one in eight Montanans living in poverty and one in seven children. The user stated, “Fraud is frequently attempted in Medicaid, but it is very rarely achieved. Basic healthcare, on the other hand, is frequently only achieved because of Medicaid.”
Other Reddit users reacted with shock and intrigue at the information the Montana citizen shared. Many agreed that despite its flaws, Medicaid remains a vital lifeline for American citizens. Unfortunately, they noted, President Donald Trump is now seeking to dismantle this safety net for countless struggling families. One commenter wrote, “Republicans are strangely against Universal Healthcare, with cries that their taxes would go up. Well, the taxes would be about equivalent to what we are all paying now in deductibles and premiums.”
