When the news broke about welfare fraud in Minnesota’s Somali community, it was largely confined to abuse surrounding the Agriculture Department’s Federal Child Nutrition Program and a Medicaid-funded autism program. However, investigators now believe that over $9 billion was stolen by more than 90 people through 14 Medicaid-funded programs. It is possible that this wave of criminal fraud is isolated to Minnesota, but it is not likely, especially since the waivers at the heart of the scandal have been granted to dozens of other blue states nationwide.

Medicaid and Medicare have always been prone to fraud, which is why the Department of Justice has had a dedicated national task force to identify and prosecute Medicaid and Medicare fraud since 2007. But what is going on in Minnesota is not typical Medicaid fraud. The guilty are not doctors who bill for more expensive services than those actually delivered, then kick money back to patients. Nor are they doctors who order tests or treatments that are not needed, so as to increase reimbursement. No doctors are even involved because Medicaid is being used to pay for nonmedical services.