My family recently left the East Coast to accompany my husband for a one-year military assignment in California. Within days of arriving, I couldn’t wait to leave.
If the high taxes, absurd regulations involving everything from cars to guns to solar panels to plastic bags, and a voting system that makes state elections as trustworthy as Venezuela’s weren’t bad enough, there’s also widespread corruption in the healthcare system. As it turns out, California officials aren’t just ignoring widespread fraud — they’re actively embracing it.
In May, Vice President JD Vance announced the Trump administration would withhold $1.3 billion in Medicaid reimbursements to the Golden State because of an ongoing scheme by our crooked state officials to siphon billions in federal dollars at the expense of U.S. taxpayers. But that hasn’t stopped the state from sneaking its hands into the till. In fact, with California’s latest State Plan Amendments, which are submitted to request how state Medicaid providers are paid, things could get even worse.
There’s been a lot of public debate recently over Medicaid financing practices in California, specifically, the state’s use of intergovernmental transfer arrangements within the Medi-Cal insurance program: a complex reimbursement gimmick that allows state and local agencies to abuse the system and launder billions in federal Medicaid dollars.
Local public healthcare providers transfer money to the state Medicaid agency, which has its spending matched with federal Medicaid dollars. The state then reimburses these local providers and pockets the difference.
IGT arrangements were intended to allow legal cost-sharing between local and state governments, but states such as California have used them to artificially inflate federal matching dollars, drawing down billions in additional federal funds.
IGT fraud has been commonly used to manipulate reimbursements to California’s Ground Emergency Medical Transportation program. The state pays state-run ambulance services more than three times per transport than it pays private ambulance providers for the same job, then sends the bill to the U.S. government at the cost of the taxpayer.
If you think that’s bad, consider this: If California’s pending SPAs are approved, it could unlock more federal funding for public healthcare providers in the form of expanded supplemental payments and rate add-ons. The Centers for Medicare & Medicaid Services is currently reviewing these 2026 amendments. Medi‑Cal is now the largest spending program in the state budget, with a projected total budget size of more than $220 billion for fiscal 2026–27, an all-time high. CMS should reject these SPAs, because approving them would reward the same financing grift that has been behind California’s laundering of federal Medicaid dollars. And Lord knows it would save the taxpayers money.
For families like mine trying to navigate the day-to-day realities of living in California, news of this rampant corruption hits hard. We value my husband’s military service beyond words, but military salaries don’t make millionaires. The state’s high cost of living translates into higher costs at the pump, higher taxes deducted from paychecks, and broader concerns about whether systems designed to serve the public are operating as efficiently and transparently as they should.
California has the highest income tax in the country, the second-highest cost of living in the U.S., and the second-highest tax burden overall. Where’s all that money going? Presumably, it’s trickling into the wealthy pockets connected to the most powerful politicians. To make matters worse, I might have difficulty finding work, because California has made working as a contractor practically impossible. So here we are, stuck paying the price of decades of liberal politicians’ horrendous policy decisions.
CALIFORNIA’S AMBULANCE FRAUD IS A RED-LIGHT EMERGENCY
Military families understand accountability. When service members make mistakes, there are consequences. When military leaders waste resources, they have to answer for it. Every member of the military takes an oath to serve this country with integrity and discipline. What’s missing in the oath that California public officials take that makes them think they don’t have a civic responsibility to govern with accountability and competence? Why do our state leaders think they get to operate under a different standard?
My military family — or anyone else’s — should not have to underwrite fraud. Not even for a little while.
Florence Baldwin is a military spouse and writer currently living in California during her husband’s military assignment. They recently relocated there from North Carolina.