Vivek Ramaswamy’s Medicaid Plan Ignores the Elephants in the Room

If Ramaswamy refuses to criticize Ohio Republicans for their failures, then how will he respond to Democrat opponent Amy Acton’s primary argument against him?

In 2013, Ohio Republican Governor John Kasich along with the supermajority Republican Ohio General Assembly expanded Medicaid under Obamacare. Ohio Republican Governor Mike DeWine with now-U.S. Senator Jon Husted standing next to him and with support from the supermajority Republican Ohio General Assembly expanded Medicaid even more over the last seven years (e.g., expanding post-pregnancy benefits from 60-days to one year; adding inpatient substance abuse treatment; including childhood behavioral services; and permitting doula services). DeWine et al. specifically made home-based services under which so much fraud is being committed by Somali immigrants and others more lucrative by increasing funding and bumping up payment rates for caregivers. Medicaid spending in Ohio surged from $18.1 billion in 2014 to $36.3 billion last fiscal year, which is a 100% increase in spending in just eleven year, or more than 9% per year.

In case you missed my point, every single person involved in this process was a Republican—all of these elephants, so to speak, were in the room laying the foundation for the programs used by Somali immigrants and others to fleece and increase costs on Ohio taxpayers. Please don’t come at me with the whole “the federal government pays 90% of the costs” faux argument. Last I checked, 10% of $18,100,000,000 is $1,810,000,000, whereas, 10% of 36,300,000,000 is $3,630,000,000, which is two times as much STATE money (we pay more, as the 90% part only covers expanded Medicaid).

Republican gubernatorial candidate Vivek Ramaswamy spent time over the weekend arguing that, under him, no stone would be left unturned in rooting out fraud thereby making Ohio’s Medicaid program squeaky-clean. He, of course, cowardly blames “the federal government” leaving Kasich, DeWine, Husted, and the Ohio General Assembly (including his running mate Ohio Senate President Rob McColley) off-the-hook for expanding Medicaid in the first place, expanding it more thereafter, making it lucrative to fleece the system, and failing to have vigorous fraud detection and prosecution measures in place. And, here is the butt-kicker, there is a solid likelihood that the fleecing of Medicaid was perfectly legal; meaning, DeWine et al. set a low bar for an adult kid to get paid handsomely to allegedly help his mother at home and proving he didn’t is nearly impossible. That is why promises to cut government spending by stamping out “waste, fraud, and abuse” rarely amount to much (see, DOGE’s results).

As usual, Ramaswamy ignored my questions to him that the media can’t seem to ask on Medicaid—seriously, Kayleigh McEnany, it didn’t occur to you to ask Ramaswamy about why there is so much still to fix in Ohio given fifteen straight years of supermajority Republican control?

Why not repeal Medicaid expansion AND root out fraud? Hell, go a step farther and become the national voice to decentralize the power and money over Medicaid to the states via the Tenth Amendment, as I have long argued and proposed during my 2023 exploratory run for Ohio Governor. Wouldn’t Ohio be better off if Ramaswamy could design a Medicaid program with 100% of the federal and state funds without the federal government dictating anything and without Ohioans subsidizing gold-plated programs in progressive Blue states like California?

If Ramaswamy refuses to criticize Ohio Republicans for their failures, then how will he respond to Democrat opponent Amy Acton’s primary argument against him:

Do Ohioans really need eight more years of supermajority Republican control from the top-to-the bottom after getting such terrible results over the last fifteen years? Our population is declining or stagnating, with many of our best and brightest fleeing to places like Colorado. Our private sector has gotten weaker-and-weaker since 2011 despite JobsOhio giving Fortune 500 companies billions of dollars in tax breaks. More than half of Ohio’s counties have hollowed out losing people and jobs while the 3C corridor collar counties around Cincinnati-Columbus-Cleveland take all of the jobs and money. Our national education ranking has plummeted as 85% of post-K-12 education funding goes to the wealthiest 15% of suburban kids going to college leaving just 15% of funding for Ohio’s neediest 85% of K-12 kids who don’t graduate from college. If you elect me governor, I’ll use divided government to finally get the results and accountability you deserve.

Watch the video below as I run through the issues and point out the fiscal reality of Medicaid as it relates to eliminating the state income tax. I think many Ohioans have grown weary of the same old rhetoric from politicians like Ramaswamy who make big, but very vague promises without any details or explanations on how his promises will be implemented. Remember, when he launched his campaign in January 2025 Ramaswamy expressly stated he was going to eliminate property taxes entirely, then the $20 billion+ fiscal reality of what property taxes fund locally hit his big plans squarely in the head. I firmly believe his detail-less rhetoric is one reason Ramaswamy trails Acton. After fifteen years of failed results by Republicans, Ohioans are rightfully suspicious of Ramaswamy’s big plans. The devil, as they say, is in the details, which Ramaswamy refuses to give us.