The Department of Government Efficiency published a trove of Medicaid billing data in February that, for the first time, allows public inspection of what companies are billing the federal health program. A Daily Wire investigation analyzing Ohio's Medicaid spending found $1 billion spent on home health care in 2024 alone, raising questions about oversight and accountability in the program's expanded personal services waivers.

The investigation, conducted by reporter Luke Rosiak over two months, examined Ohio's Medicaid waiver programs that allow payments for 'personal services' including homemaking, cooking, cleaning, and what billing records describe as 'companionship & conversation.' Unlike nursing home or hospital care, these services are performed in private residences with no on-site federal oversight.

What the Right Is Saying

The Daily Wire investigation argues that the system has become ripe for abuse, with relatives billing Medicaid for services performed within their own households. The report identifies what it calls 'Medicaid Millionaires' — operators of home health companies who have accumulated significant wealth through the program.

Republican critics in Ohio have called for stricter oversight and verification requirements. State legislators have proposed bills requiring background checks, mandatory skill certifications, and third-party verification that services were actually rendered.

The investigation found one Columbus building housing 94 different Medicaid billing companies, which collectively billed $66 million over several years. Critics argue this represents a failure of due diligence by federal and state administrators responsible for program integrity.

What the Left Is Saying

Medicaid advocates argue that home health programs represent a cost-effective alternative to institutional care. The Centers for Medicare and Medicaid Services has promoted home-based care as a way to keep elderly and disabled beneficiaries in their communities rather than nursing homes, which are significantly more expensive per capita.

Democratic state officials in Ohio have defended the waiver programs as essential for vulnerable populations. Supporters note that Ohio is one of several states granted federal waivers allowing expanded Medicaid coverage, a policy framework that has existed under administrations of both parties.

Disability rights advocates point out that family caregivers often provide irreplaceable care that cannot be replicated by institutional settings. They argue that restricting payments to non-family members could paradoxically harm the very beneficiaries the program aims to serve.

What the Numbers Show

Ohio spent approximately $1 billion on home health care through Medicaid in 2024, according to Daily Wire analysis of DOGE-published data. The state is one of several that has received federal waivers expanding Medicaid well beyond its original purpose, allowing personal services payments including cooking, cleaning, and companionship.

The Centers for Medicare and Medicaid Services reports that national Medicaid spending on home and community-based services reached approximately $87 billion in fiscal year 2023, representing significant growth from prior years as the program has shifted toward community-based care models.

A single address at 6161 Busch Boulevard in Columbus contains 94 registered Medicaid billing companies. The building billed taxpayers an estimated $66 million over a multi-year period, according to records analyzed by the Daily Wire.

The program's structure allows relatives of Medicaid beneficiaries to receive payment for personal services without requiring healthcare worker certifications or credentials.

The Bottom Line

The DOGE data release has opened a window into previously opaque Medicaid billing practices. Ohio's $1 billion in home health spending represents just one state's portion of a national program that continues to grow.

What remains unclear from the investigation is what percentage of payments represent legitimate medical need versus potential abuse. The Daily Wire plans additional reporting on specific company owners and their backgrounds.

State and federal officials have not yet responded publicly to specific findings in the investigation. Program defenders note that home-based care costs significantly less than institutional alternatives, while critics argue that without verification requirements, there is no way to ensure taxpayer dollars are actually purchasing services rendered.