These include bills for in-home care and other services covered by the two states’ Medicaid programs for low-income residents. But the Trump administration’s latest moves are part of a much broader history of weaponizing Medicaid fraud and abuse – both real and imagined. That led to the Medicare-Medicaid Anti-Fraud and Abuse Amendments of 1977, which established the national Medicaid Fraud Control Units program. The state-run Medicaid Fraud Control Units received generous federal matching funds to investigate and prosecute fraud. The most serious Medicaid fraud was generally committed by healthcare providers and contractors, not patients.