Cutting aid for children is unhelpful. Here's where to find abuse. | Opinion
Justifications for deep cuts to health care, nutrition programs, and child care and other publicly financed services found both in the federal budget reconciliation legislation and in many of the Department of Government Efficiency (DOGE) actions are that they are necessary to root out “fraud and abuse.”
Yet we could protect these essential services for children and families, and reduce government waste, if we had the will instead to go after fraud and abuse where it is most prevalent and costly. Instead, Congress and the president are headed in the opposite direction.
As someone who has spent decades working on child and family policy, I’ve seen firsthand how well most public programs aimed at children actually work. Medicaid, SNAP, WIC, Head Start, IDEA and Title I, and child welfare services are among the most effective and accountable programs in government. Iowans know that public schools are the foundation for our future. Their benefits are clear and they are life-changing for millions of children and families.
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Yet instead of investing in what works, the current federal budget proposals in budget reconciliation and through actions of DOGE are gutting these programs. Congress is moving to slash Medicaid and reduce nutrition assistance and doing great harm to the people receiving those services and to state governments given increased responsibility and reduced funding to pick up the pieces.
If lawmakers are serious about cutting waste, here are some areas where they should look:
Vendor fraud in health care: Each year, tens of billions of dollars are lost to fraudulent billing schemes in Medicare and Medicaid — not by families, but by providers. These include billing for services never delivered, double billing, upcoding, and phantom patients. The Department of Justice regularly recovers billions in fraud settlements, but enforcement remains under-resourced and has been subject to DOGE cuts that further limit its capacity. Strengthening audit systems and prosecuting fraud and investing in stater Medicaid fraud units would save real money without punishing children or families.
Tax evasion by the wealthy and by powerful and profitable corporations: The IRS estimates more than $600 billion in taxes go uncollected each year, largely due to underreporting by high-income individuals and corporations. Increased enforcement capacity directed to this in the Biden administration was among the first places where DOGE and presidential orders cut funding and personnel. Restoring IRS enforcement capacity would generate hundreds of billions over a decade. Yet instead, additional tax breaks go to those who already aren’t paying what they owe. Working-class families pay what they owe. The wealthy should, too.
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Corporate abuse and white-collar crime: From price-fixing to corporate tax shelters to wage theft, financial abuse in the private sector dwarfs anything found in safety net programs. Yet prosecutions of corporate crime are at historic lows. Going after these forms of white-collar theft not only protects public revenue; it restores faith that the system is not rigged against everyday Americans. Tackling fraud, waste and abuse requires government attention and response. We must combat “crime in the streets,” but we also must combat “crime in the suites” if we are to truly protect the American public.
Simply put, the problem of “fraud and abuse” is not with poor families and certainly not their children gaming the system. It’s powerful actors exploiting it. It’s political choices that allow this exploitation to continue and be less subject to control.
Cutting programs that feed children, keep them healthy, and help them learn is not fiscal prudence. It’s cruelty disguised as reform. It deepens public cynicism that government serves the rich and punishes working Americans who play by the rules and struggle to get ahead. Most important, it jeopardizes our very future.
If we want a government that works, for all of us, we should start by protecting our most effective programs and cracking down on the real fraud. That’s not just good economics. It’s basic fairness. it's the kind of leadership working families want and deserve.
Charles Bruner is a former Iowa state legislator who served from 1978 to 1990. He served as the founding director of the Child and Family Policy Center (now Common Good Iowa) from 1990 until 2015.
This article originally appeared on Des Moines Register: Go after fraud and abuse where it actually exists | Opinion
