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A House subcommittee held a hearing on April 16, 2024, that revealed some remarkable problems with federal spending.

"Since fiscal year 2003, federal agencies have reported an estimated $2.7 trillion in total improper payments," Rep. Morgan Griffith (R-Va.), chairman of the House Energy and Commerce Oversight and Investigations Subcommittee, said at the start of this hearing.

One of the witnesses in front of him that day was Gene Dodaro, the comptroller general of the United States, who runs the Government Accountability Office.

"A recent Government Accountability Office report disclosed that in fiscal year 2023 alone, government-wide improper payments amounted to $236 billion," Griffith said.

"For fiscal year 2023, GAO reports Medicare reporting approximately $51.1 billion -- let me repeat that, $51.1 billion -- in improper payments and Medicaid reporting $50.3 billion in improper payments," said Griffith.

"Furthermore," he said, "investigations found that in just two years, California and New York alone were responsible for $1.7 billion in Medicaid payments to approximately 1.6 million ineligible recipients, with an additional estimated $4.3 billion directed toward nearly 4 million potentially ineligible enrollees."

"Our duty," said Griffith, "is to ensure that not only are these funds recovered, but that stringent preventive measures are put in place."

What does the government consider an "improper payment"?

"Improper payments," Comptroller General Dodaro explained in his written testimony, "generally include payments that are either in an incorrect amount (overpayments and underpayments) or those that should not be made at all."

"While improper payments can include, for example, overpayments made in error, they also include those resulting from fraud," Dodaro said in his written testimony.

In the months following Dodaro's testimony, did the government fix this improper-payments problem? No. Improper payments decreased, but they were still significant.

Eleven months after Dodaro testified in the Oversight and Investigations Subcommittee, the GAO released a report on the improper payment estimates for fiscal 2024. "Since fiscal year 2003, cumulative improper payment estimates by executive branch agencies have totaled about $2.8 trillion, and the actual amount of improper payments may be significantly higher," said this report, which was published on March 11. "Reducing improper payments is critical to safeguarding federal funds."

This only tells part of the story -- because many federal agencies do not estimate the improper payments they have made.

"The improper payment estimates do not represent the full extent of government-wide improper payments," said the report. "The total of fiscal year 2024 improper payment estimates represent a small subset of all federal programs. For example, some programs that agencies have determined are susceptible to significant improper payments, such as the Department of Health and Human Services' (HHS) Temporary Assistance for Needy Families (TANF), do not estimate improper payments. In addition, IGs (inspector generals) have reported that agencies' improper payment estimates are unreliable for some programs."

"Our analysis of agency data shows that 16 agencies reported improper payment estimates across 68 programs, representing a small subset of all federal programs," the report said.

This "small subset" that did report their improper payment estimates "reported about $162 billion in improper payment estimates for fiscal year 2024," which was "a decrease of about $74 billion from the fiscal year 2023 total," said the report.

Of this $162 billion in estimated improper payments, according to the report, $121 billion was reported in just "five program areas." These included $54 billion in Medicare; $31 billion in Medicaid; $16 billion in the Treasury Department's Earned Income Tax Credit; $11 billion in the Department of Agriculture's Supplemental Nutrition Assistance Program (food stamps); and $9 billion in the Small Business Administration's Restaurant Revitalization Fund.

To put the $162 billion in estimated improper payments made by the "small subset of all federal programs" that actually reported their estimates, it is worth noting that many federal departments did not even spend a total of $162 billion in fiscal 2024. For example, the Department of Homeland Security -- which is responsible for securing our borders and enforcing the immigration laws -- spent $89.29 billion in fiscal 2024, according to the Monthly Treasury Statement.

The Department of Justice, which is responsible for enforcing federal laws, spent $43.995 billion. The Department of State, which is responsible for advancing American interests in the world, spent $37.017 billion.

The One Big Beautiful Bill Act that passed the House last month included a number of provisions dealing with Medicaid. As summarized by the Kaiser Family Foundation, some of these provisions are aimed at making sure Medicaid recipients are actually eligible for the program. One provision summarized by KFF, for example, "(r)equires states to verify that individuals applying for coverage meet requirements for 1 or more consecutive months preceding the month of application and that individuals who are enrolled meet requirements for 1 or more months between the most recent eligibility redetermination (at least twice per year)."

Another "(r)equires states to conduct eligibility redeterminations at least every 6 months for Medicaid expansion adults."

These are not unreasonable requirements to impose on a program that, according to the Government Accountability Office, made an estimated $31 billion in "improper payments" in fiscal 2024.

To find out more about Terence P. Jeffrey and read features by other Creators writers and cartoonists, visit the Creators webpage at www.creators.com.

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