In 2025, Medicare and Medicaid officials made an estimated $94 billion in improper payments — outlays that were either excessive or should not have been made at all — according to a new report from the Government Accountability Office (GAO), the investigative arm of Congress.

Those improper payments by the two largest federal health care programs were among a total of $186 billion for 64 separate programs administered by the federal government and examined by GAO in this report. That total for 2025 represents a $24 billion increase over the 2024 total of $162 billion. The increase of improper payments came despite the greatly heightened official and public focus on the issue, thanks to President Donald Trump, Elon Musk, and the Department of Government Efficiency (DOGE).

“Agencies reported that about $153 billion (approximately 82%) of this total was the result of overpayments. However, these estimates do not represent the full extent of government-wide improper payments. For instance, the $186 billion does not include certain programs that agencies have determined are susceptible to significant improper payments, such as the Department of Health and Human Services’ Temporary Assistance for Needy Families (TANF). Of the programs reporting improper payment estimates for fiscal year 2025, 19 reported improper payment rate estimates of at least 10 percent, including six programs whose rates exceeded 25 percent,” GAO said in its report.

A total of $21 billion in improper payments were made under the Earned Income Tax Credit (EITC) program, representing 11% of the $186 billion total, while the Shuttered Venue Operators Grants program came in with $10 billion in improper payments, or 5% of the total. The remaining $51 billion were attributed to all of the other federal programs examined, according to GAO.

“Improper payments — those that should not have been made or were made in incorrect amounts — have consistently been a government-wide issue. Since fiscal year 2003, cumulative improper payment estimates by executive branch agencies have totaled about $3 trillion, though the actual amount may be much higher. Reducing improper payments is critical to safeguarding federal funds. GAO performed this audit in connection with the statutory requirement for GAO to audit the U.S. government’s consolidated financial statements. This report provides an overview of federal agencies’ improper payment estimates for fiscal year 2025,” the report explained.

House Republicans are moving to bring about major reforms in how the federal government manages its many benefits programs, including tough new reporting and accounting requirements aimed directly at the improper payments problem, beginning with “The Expedited Transparency Act,” (ETA) which mandates making virtually all federal spending decisions available to the public via USASpending.gov within three days.

The measure consists of a mere 81 words, but its enactment could dramatically impact the debate over government spending simply by mandating that the public must be informed no later than three days after an expenditure is officially made. Making public access a matter of a few days instead of a month will enhance the public’s ability to hold public officials accountable for the spending decisions they make.

The ETA is the bipartisan work of Reps. Josh Brecheen (R-Okla.) and Chip Roy (R-Texas), along with Rep. Jimmy Panetta (D-Calif.).

House Committee on Oversight and Government Reform Chairman James Comer (R-Ky.) will gavel to order a major markup session of the panel on April 29, during which nine separate bills will be on the table in what is likely to be a lengthy hearing.

“Let’s be clear: fraud in federal programs has gone unchecked for far too long,” Comer stated. “The House Oversight and Government Reform Committee has acted swiftly to expose widespread theft of taxpayer funds, working alongside the Trump Administration to crack down on fraud and hold fraudsters accountable nationwide. Our oversight has exposed how fraudsters in Minnesota stole taxpayer dollars meant to feed children, support autistic kids, and house low-income seniors and Americans with disabilities. We are now moving to pass strong legislative reforms to stop fraudulent payments before they go out the door and ensure taxpayer-funded programs are working as intended for the American people.”

Among the nine measures will be three specifically targeting the improper payments problem, including:

• Pre-Payment Fraud Prevention and Treasury Data Access Act (H.R. 8463): This bill strengthens the federal government’s financial oversight and controls by directing the U.S. Treasury to work with agencies to verify payment and payee information before payments go out the door. It expands tools like the U.S. Treasury’s Do Not Pay system and ensures federal agencies have better access to accurate data to identify improper and fraudulent payments. 
• Stopping Fraudulent Payments Act (H.R. 8464): The legislation tackles the widespread “pay and chase” problem by preventing federal agencies from making payments when an agency has determined there is an elevated risk of fraud or the payment is likely to be improper. The bill also gives the U.S. Treasury new authority to return payment requests to agencies if they appear to be at risk for fraud. These reforms shift agency actions from recovery to prevention that protects taxpayer dollars. 
• Fraud Prevention and Accountability Act of 2025 (H.R. 8312): The bill establishes a permanent Inspector General for Fraud, Accountability, and Recovery (IGFAR) within the U.S. Treasury to assume and expand the data analytics and investigative functions of the Pandemic Response Accountability Committee after 2028. The bill strengthens the Treasury’s Fiscal Service program integrity role, including administration of the Do Not Pay system and development of a government-wide data analytics platform and requires data access agreements to support both pre-award fraud prevention and post-award investigative activities.

The multiplicity of legislative proposals to address waste, fraud, and abuse in federal, state, and municipal government programs reflects the enormity of the problem. Billionaire entrepreneur and former Department of Government Efficiency founder Elon Musk left the program in early 2025, but his assessment in a December 2025 tweet of the true extent of waste, fraud, and abuse in the federal budget dwarfed the GAO’s figures: “My lower bound guess for how much fraud there is nationally is 20% of the federal budget, which would mean $1.5 trillion per year. Probably much higher.”

If Musk is in the ballpark of how much is wasted on things like improper payments, one wonders if Trump will be able to eliminate it by the end of his second term in the Oval Office in January 2029.