House Republicans Want to Spend $28 Billion Fighting Health Care Fraud. A Preliminary CBO Estimate Says It Would Save $168 Billion.

• $28,000,000,000 new funding H.R. 9811 would add to the Health Care Fraud and Abuse Control Program over four years (FY2027-FY2030) — a funding increase to the existing DOJ/HHS-OIG/CMS program, not a new fraud-detection mandate on its own — H.R. 9811 bill text
• $168,000,000,000 net savings over 10 years, per a preliminary CBO estimate the bill's sponsors and CRFB are citing — not a formally filed CBO score of enacted legislation — CRFB, July 27, 2026
• $186,000,000,000 federal improper payments the Government Accountability Office identified across 64 programs in fiscal year 2025 alone — GAO-25-107743
• $2,800,000,000,000 cumulative federal improper payments government-wide since GAO began tracking the figure in 2003 — GAO
• 13-to-1 the existing HCFAC program's actual 2025 return on investment — HHS Inspector General T. March Bell says it "returned nearly $13 for every dollar spent in 2025" — better than H.R. 9811's own projected 7-to-1 return, which sponsors call the more conservative figure — HHS-OIG

Seven House Republicans introduced a bill on July 21, 2026, that would add $28,000,000,000 in new federal funding to a health care fraud-fighting program that has existed since the Clinton administration. According to a preliminary Congressional Budget Office estimate that the bill’s sponsors and the nonpartisan Committee for a Responsible Federal Budget are now citing, that investment would return $168,000,000,000 in net savings over the next ten years.

The bill is H.R. 9811, the Anti-Fraud Fund Act of 2026. It is not, on its own, a new fraud-detection technology mandate — it is a funding bill. It directs $7,000,000,000 a year, from fiscal year 2027 through fiscal year 2030, into the Health Care Fraud and Abuse Control Program, known as HCFAC, the joint Justice Department, HHS Inspector General, and CMS operation that has policed Medicare and Medicaid fraud since 1996.

The bill has not been marked up by either committee it was referred to, has not passed the House, and has no identified Senate companion. It is, in other words, still early — and the $168,000,000,000 figure attached to it is a preliminary estimate, not a formally filed CBO score.

Rep. Blake Moore (R-UT-1), chairman of the House Health Care Task Force, introduced H.R. 9811 with Rep. Jodey Arrington (R-TX-19), chairman of the House Budget Committee, as lead co-sponsor. Five more Republicans signed on: Reps. Jay Obernolte (R-CA), Glenn Grothman (R-WI), Mike Carey (R-OH), Addison McDowell (R-NC), and Lloyd Smucker (R-PA), the Budget Committee’s vice chairman. All seven are House members; no senator has introduced a companion bill, and the legislation has been referred to the Ways and Means and Energy and Commerce Committees.

The new money would fund additional DOJ and HHS-OIG attorneys and investigators, expanded data analytics for flagging suspicious billing patterns, more provider audits, and higher payouts for whistleblowers who report fraud. Moore and Arrington describe the goal as a shift from “pay and chase” — recovering stolen money only after the government has already paid a fraudulent claim — to “prevent and detect,” stopping the payment before it goes out the door.

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The Committee for a Responsible Federal Budget laid out the math in a July 27, 2026 analysis: $28,000,000,000 invested in HCFAC over four years would generate roughly $196,000,000,000 in gross fraud recovered or prevented, netting $168,000,000,000 in savings after subtracting the cost of the program itself — a return of roughly seven dollars for every dollar spent. CRFB frames the health programs the bill targets as “the government’s largest sources of improper payments,” but its own write-up is explicit that the $168,000,000,000 figure is a preliminary CBO estimate the bill’s sponsors are citing — not a formally filed, line-by-line CBO score of enacted legislation. That distinction matters: preliminary estimates move, and they carry more uncertainty for a bill that has not yet cleared a single committee vote.

House Budget Committee Republicans, whom Arrington chairs, held a hearing in the run-up to introduction titled “Reversing the Curse,” framing waste and fraud recovery as central to the panel’s 2026 agenda and building the case for the funding increase that became H.R. 9811.

The backdrop for the bill is a federal improper-payments problem that has proven durable across administrations. The Government Accountability Office reported $186,000,000,000 in federal improper payments across 64 programs in fiscal year 2025 alone, and $2,800,000,000,000 cumulatively since it began tracking the figure in 2003 — including more than $150,000,000,000 in each of the last seven years. Medicare and Medicaid have both sat on GAO’s High-Risk List for years.

CMS’s own fiscal year 2025 improper-payment rates put numbers on each program: Medicare fee-for-service, 6.55 percent, or $28,830,000,000; Medicare Part C, 6.09 percent, or $23,670,000,000; Medicare Part D, 4.00 percent, or $4,230,000,000; Medicaid, 6.12 percent, or $37,390,000,000; and CHIP, 7.05 percent, or $1,370,000,000. An important caveat belongs alongside those figures: CMS itself attributes 77 percent of Medicaid’s improper-payment total to insufficient documentation, not proven fraud. An improper payment and a fraudulent one are not the same thing, and the bill’s backers do not claim otherwise — their argument is that the documentation gap and the fraud gap both shrink when the government has more capacity to check a claim before it pays it.

“If it smells like fraud, we're not paying for it anymore.”

Dr. Mehmet Oz, CMS Administrator · 2026

HHS Inspector General T. March Bell has pointed to HCFAC’s own recent track record as evidence the underlying model already works: the program, he said, “returned nearly $13 for every dollar spent in 2025.” That 13-to-1 return is measured, historical performance; the 7-to-1 figure attached to H.R. 9811 is a forward-looking projection, and sponsors describe it as the more conservative of the two numbers. Federal prosecutors, meanwhile, are already working existing fraud authority hard:

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H.R. 9811’s sponsors are not the only Republicans tying fraud enforcement to specific state governments. Ways and Means Chairman Rep. Jason Smith (R-MO) used the April 21, 2026 hearing above to call out Gov. Gavin Newsom (D-CA) and Gov. Tim Walz (D-MN) by name over state Medicaid oversight failures, arguing that state-level program integrity — not just federal enforcement — determines how much fraud gets through in the first place.

That state-level fight sits inside a larger administration push. Vice President JD Vance now leads a separate cross-agency effort, the Task Force to Eliminate Fraud, distinct from H.R. 9811 but aligned with its stated goal. President Trump named Vance to the role on April 3, 2026, framing the effort as aimed squarely at Democratic-run states:

Democratic officials have pushed back hard on that framing. Gov. Walz argued publicly that the fraud rhetoric is cover for a different policy goal entirely:

H.R. 9811 remains, as of publication, a bill referred to two committees with no markup scheduled and no Senate companion identified. Nothing about its $168,000,000,000 projection is locked in; it would need to survive committee, a House floor vote, Senate passage, and a formal CBO score before that figure means anything beyond an estimate sponsors are using to build early support.

Arrington has separately cited broader figures than the CRFB analysis — numbers this site attributes to him directly because they carry far less rigorous sourcing than the $168,000,000,000 estimate. He has said $275,000,000 is stolen from Medicare and Medicaid daily, that federal fraud broadly totals $500,000,000,000 annually, and that unchecked fraud could cost $6,000,000,000,000 over ten years with interest. HHS Secretary Robert F. Kennedy Jr. has cited a separate, lower figure specific to health care fraud: roughly $100,000,000,000 a year. None of these broader numbers carries the same CBO-adjacent sourcing as the bill’s own $168,000,000,000 projection, and they should be read as sponsor and administration claims — not independently scored figures.

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