Since returning to the White House, President Donald Trump has made combating fraud a centerpiece of his administration. Trump has said he will target fraud in Medicare, Medicaid, and Social Security programs, and his Republican allies in Congress have made combating fraud a key argument in their plans to slash Medicaid. Trump also has empowered the Elon Musk-led Department of Government Efficiency to make massive cuts to government spending, often claiming to snuff out fraud and waste in the process. 

Trump’s present-day crackdown starkly contrasts with his history of showing leniency to convicted fraudsters. In his first and second terms, Trump has granted pardons or commutations to at least 68 people convicted of fraud crimes or interfering with fraud investigations, according to a KFF Health News review of court and clemency records, Department of Justice press releases, and news reports. At least 13 of those fraudsters were convicted in cases involving more than $1.6 billion in fraudulent claims filed with Medicare and Medicaid, according to the DOJ. 

In interviews with KFF Health News, two experts on health care fraud said that Trump’s claimed focus appears to be a pretext for slashing spending that was legally appropriated by Congress. 

“What’s been the focal point to date of the administration is not what anybody has ever referred to as health care fraud,” said Jacob Elberg, a former assistant U.S. attorney and law professor at Seton Hall University. “There is a real blurring — a seemingly intentional blurring — between what is actually fraud and what is just spending that they are not in favor of.” 

Jerry Martin, who served as a U.S. attorney for the Middle District of Tennessee under President Barack Obama and now represents health care fraud whistleblowers, said Trump’s stepped-up interest may embolden informants to come forward. 

“I’ve had clients repeat back to me ‘President Trump says fraud is a priority,’” Martin said. “People are listening to it. But I don’t know that what he’s saying translates into what they believe.” 

Even so, Trump’s past leniency to fraudsters might discourage the Justice Department from pursuing the whistleblowers’ claims, Martin said. 

“There are a lot of rank-and-file people who are operating at the lowest point in their professional careers, where they’ve seen a lot of their work essentially be water under the bridge,” Martin said. “That’s got to be really demoralizing.” 

The White House did not respond to requests for comment.