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Ohio gubernatorial candidate Vivek Ramaswamy detailed how Medicaid fraud raises the costs of healthcare for people playing by the rules, in an exclusive interview with the Ruthless Podcast released Friday morning.
“I would say my overarching view is that Medicaid fraud is real,” the Republican nominee for governor said in the interview. “It is not the only thing we’re going to need to do to fix the healthcare system. You prosecute the bad guys, you take the billions of dollars and put it in the pockets of the people who are actually working hard and following the rules.”
On the campaign trail, Ramaswamy recently unveiled a three-part plan to address Medicaid fraud in Ohio. The approach emphasizes syncing federal-state incentives, streamlining the bureaucracy, and prioritizing fraud prosecutions.
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“Look at over the last 10 years, you’re looking at about $1.1 trillion in improper payments across the state and federal level combined,” Ramaswamy told the show. “So if you look at that same 10-year period, Medicaid expenses have gone from $27 billion in Ohio, in just a decade, up to $47 billion, and yet the number of enrollees is only up by 100,000.”
The push in Ohio comes as Vice President JD Vance’s White House Anti-Fraud Task Force continues its work to uncover fraud nationwide. The group has already uncovered $1.4 billion of home health and hospice waste.
Vance’s committee has taken a collaborative approach to working with state governments to protect taxpayer dollars. Vance has cited Ohio and Maryland as examples of states taking fraud seriously.
Ramaswamy, a successful entrepreneur, rose to political prominence after he published Woke, Inc.: Inside Corporate America’s Social Justice Scam in 2021. He then ran for the Republican presidential nomination in 2024 before dropping out and endorsing Donald Trump. He went on to help lead the Trump administration’s Department of Government Efficiency (DOGE) with Elon Musk, although he left after less than three months last year.
TRUMP-BACKED VIVEK RAMASWAMY WINS OHIO GOP GUBERNATORIAL PRIMARY, WILL FACE DEMOCRAT AMY ACTON
Elon Musk and Vivek Ramaswamy. (Getty Images)
Earlier this week, podcast co-host John Ashbrook published an opinion piece on Digital, underscoring that voters want action on fraud ahead of the 2026 midterm elections.
Ashbrook, a Cincinnati native with more than 20 years of experience advising Senate campaigns, expressed optimism about Ramswamy’s electoral chances. He noted a shift in the campaign over the last few weeks, with fraud increasingly centered in the discourse.
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“I’m telling you over the last few weeks, the thing that you started talking about that I think is on the minds of a lot of people is fraud,” Ashbrook said. “[Democratic nominee for Governor Amy Acton] is part of the problem. She was the health director.”
“Those Medicaid dollars flow through the Department of Medicaid, but also through the Department of Health in Ohio,” Ramaswamy said. “She led to that, while a lot of that fraud festered, and while she shut down our schools during COVID-19.”
Ramaswamy’s interview took place as part of the Ruthless Midterm Interview Series, an ongoing initiative to interview major candidates across the country. The hosts have already interviewed candidates in 15 states, with more scheduled ahead of the November midterms.
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After winning the May primary, Ramaswamy faces Acton in the general election on Nov. 3. No Democrat has been elected governor of Ohio since 2006.
Ohio, long a battleground in presidential elections, went handily for Trump in 2016, 2020 and 2024.
