ILLEGAL PAYMENTS EXPOSED: Trump uncovers massive Medicaid fraud

Welcome back. Well, the Senate taking a major step toward reopening the government overnight voting 60 to 40 to break the filibuster and Advance a spending measure a final package vote set for the coming days And if the bill clears the Senate it will move to the house Where once it's passed will move on to the president's desk for signage and then the government can officially reopen which have been the Democrats' main sticking point in this record-long standoff 41 days. Open enrollment is currently underway.

Americans have until December 15th to enroll for health coverage, beginning New Year's Day. Joining me now is Medicare and Medicaid Services Administrator Dr. Mehmet Oz. Dr. Oz, it's great to see you. Thank you so much for being here this morning.

Always love spending time with you, Maria.

Well, this is a long-fought fight. I want to talk to you about everything you just did in the Oval Office the other day with the GLP-1 drugs and how President Trump and you and your agenda are making things more accessible for people at lower prices. But first, give us your reaction to the government likely reopening this week

and what was achieved last night.

I'm over the moon. Happy that we're gonna get the government open, get all these federal workers back into their offices. For me, it means I've got actuaries and insurance experts that can help crunch the numbers and figure out what makes sense. It's also the right thing for the American people. You should not be negotiating important issues. In this case the Affordable Care Act

and Medicaid under an extortionary situation where you're holding the government hostage. So opening the government up allowing it to go back to work getting air traffic control and all the other things you've been talking about. For me, a focus on health care is important. And you brought up this issue of a potential vote on the ACA. This whole debate for Republicans is about fraud, waste and abuse. During COVID, there were these enhanced, very generous subsidies given because it was an

emergency to Americans who are in that category of one to 400 percent of the poverty level. They even gave it to folks who are making more than four times the poverty level because they wanted to be generous. It was. Covid was a pandemic. The pandemic's over. We're not at war with the virus anymore. So Republicans are arguing all the shortcuts that were created over the last several years that led to fraud, waste and abuse of massive numbers need to be

reformed. And I'll give you just two numbers that listeners ought to be aware of. Half the people, half the 24 million people on Obamacare don't use the insurance. Now, if you buy insurance with your hard-earned dollars, you're going to probably use it for a prescription, a doctor's visit. No use. We believe half of those people, 6 million, literally don't know they have insurance,

don't care that they have insurance. They're phantom enrollees. So that means the taxpayer is paying for insurance on, for example, Medicaid and paying for you to have an Obamacare policy. Full freight. The insurance companies are happy with that. No one seems to mind, except, of course, the taxpayers who have to foot the bill twice.

So these are the kinds of things you've got to clean up in order to get the ACA into a different place for next year. But meanwhile, open enrollment, as you said, is progressing. No hitches at all. Folks are signing up. Most people have very generous policies. And here's the basic number.

The average person on Obamacare pays $50 a month for their insurance now. It used to be $37 this year, which means you're paying $13 more next year than this year. And that's the reason we shut the government down for six weeks, according to the Democrats.

I mean, there's also fraud, which was uncovered. I mean, you were able to uncover more than $1 billion in Medicaid money being spent on illegal immigrants.

Just found it out last week. The president was asking. The Democrats said it wasn't a problem. They wanted to repeal the one big beautiful bill. So we decided to trust but verify. So we audited the books of six states.

We only have a few months of data from only a few of those states. We already have over a billion dollars that we've identified of monies that were spent from to get federal taxpayer dollars spent on illegal immigrants.

And here's the catch. If you're in California and you want to give Medicaid to illegal immigrants in California, maybe that's your choice. We can debate that later. But you can't take money from taxpayers in Texas and Florida and pay for your illegal immigrants because they're not doing that in Texas and Florida. And that's what's been tolerated for far too long. It undermines the system and my job is to protect our most vulnerable. I am laser focused and I'm a heart surgeon. So, you know, my day job is taking care of people who are struggling with health issues. I want to make sure they have coverage. But if you dilute the coverage that we've dedicated to folks on Medicaid or to the ACA, to people

who are not eligible for these programs, that's not only wrong, it's illegal and we're going

to stop it. Unbelievable. I mean, what an incredible opportunity for you, Dr. Oz, after this incredibly stunning and proud career that you've had in medicine, to be able to move the needle for average people in America with this most favored nation policy on pricing, as well as allowing access to these GLP-1 drugs. I saw you in the Oval Office with President Trump last week making these announcements, this major deal that the president did with Eli Lilly, Novo Nordisk, to make GLP-1 weight-loss

Tell us about this major announcement, your role in it, and the major benefits that you're expecting.

So, the president early on said that he's not going to allow Americans to pay three times more on average for the same medications made in the same factories than the Europeans are paying. It's just not right. Just like NATO mandated that we have an equalization of responsibility fighting an external threat. We do the same thing internally. So the president literally calling me all the

time. We were joking about it in the Oval Office. You were there once when this happened. But he would call and check in. And you know he's a great leader. He wants to know what's happening. And he's been passionate about this for decades. It's just wrong that Americans are taken advantage of. So we went to all the pharma companies with the president's guidance and Secretary Kennedy's passionate about this. But the people who really did the work, Maria, are Chris Klump, John Brooks, Inma Hernandez. which was equalization of drug prices.

So we now have, in America, most favored drug pricing for the single largest, most expensive category, which is these GOP-1 weight loss drugs. Maria, the Upper East Side of Manhattan is currently the top place where you get GOP drugs. That's not where the obesity epidemic is hitting us. It's hitting us in Mississippi and Appalachia

and poorer parts of the country. So this program allows all Americans to get access to drugs at a fraction of what they currently cost. Right now, drugs, if you buy them at least, it's about $1,200, $1,300 a month. The drugs now are gonna be about $125 on average.

There are different tiers. We have a program to allow it to go to Medicaid patients called Generous that Abe Sutton created that is designed to allow governors now to dramatically drop the potential cost of these drugs for the Medicaid population when we really need help. That's where the obesity epidemic is literally killing us. And we have a moral hazard. On the Upper East Side of Manhattan, you know, an affluent area is enjoying as much of these drugs as they want and losing

weight but the poor parts of the country are dying of diabetes and hypertension, heart attacks and strokes and kidney failure. So now we don't have that moral hazard anymore. This generous model is going to allow it for the governors. We have Medicare, the program I run allowing Medicare beneficiaries to get the drug for 50 bucks a month.

You pay 50, we'll pay 200. Taxpayers happy and here's why. Within two years of that ink drying in the Oval Office on Thursday, we predict we'll be saving money. There's so much benefit from reducing the expenses of taking care of dialysis patients and heart attack patients and dementia patients that we will be saving money for the taxpayer

by buying these cutting edge drugs. And these pharma companies are rapidly evolving this technology. We have pills coming out. I just learned I'll break it to your audience. By March, we will have pills replacing the injections for these patients as well. That's 150 bucks. It's a bit cheaper. So we are dramatically changing the face of obesity. But one big statement, one big plea. Maria, you were kind in your words to me earlier. My whole life has been built on educating folks, empowering people.

Lose weight the right way. Diet, exercise. Obesity is not a shortage of GLP-1 drugs in your bloodstream. However, if you can't lose weight, these are an important crutch. They absolutely work, reducing about 20 percent of the obesity that we're seeing now in folks who are struggling. And we think there's going to be massive uptake of these drugs so that by the time, a year

from now, when we speak—and we've spoke many times between them—but by a year from now, Maria, we'll have lost 135 million pounds as a country. That's a lot of lives saved.

That's incredible. And I think the point that you're making is so critical, so I want to underline it. This is not just giving access to a pill that makes you skinny. You believe that these pills do more than just attacking a person's weight, because we've seen medical journal research that says that these pills are effective in helping to ward off against dementia, helping to ward off against heart disease, because it's really obesity that's the killer.

That's going to lead to diabetes. That's going to lead to heart disease. That's an important point, I think, that we need to underline, and also the fact that some people don't like the fact that you have to give yourself an injection, and you just revealed to us that we're going to have pills We spoke with the CEO of Eli Lilly here just a few weeks ago on his efforts to get the pills out in the market.

Talk to us about the bigger, broader point about these drugs in terms of our overall

health.

So, I'm a big proponent of the make America healthy again movement created by secretary Kennedy I don't think we'd be having some of these discussions about his bold leadership. The president has been passionate about this and here's the story. My fundamentally is not making it easier to be healthy in America. We have to automate

the system better food supplies we're talking with Brooke grounds it and actually working hard at this we have dietary guidelines. All that's going to happen. But in the meantime, we have a bigger problem with obesity than we have ever had in our history. We're twice as fat as Europe. That's why we're spending twice as much per capita on health care as they are in Europe. And so if we drop the obesity incidence in this country, all the downstream problems that arise from the inflammation are also going to get better. And it starts with diabetes and hypertension, but it progresses to end organ failure that

is really expensive to treat. And it's wrong that some Americans can treat this problem, can crutch on these cutting-edge medications and some Americans don't have access to them. And I don't want to have a scenario, you don't want to have a scenario where in America we have an unfair health care system if you're an American you deserve to have access to life saving medications whether it's cancer

autoimmune problems or in this case, I'll be city epidemic that we know stripping the guts out of the livelihood of Americans we want to be fit at 5th nation is productive we want Americans to the flourishing getting back to work not having to miss important events in their lives because obesity stripped away their vitality. So let's stop making this about a moral failing and focus on the fact that in some cases

we have a biologic solution. And we also want innovation. Maria this is critical for the audience. The president said I don't If we put price controls in place we'll destroy the industry. If we negotiate with them with top tier negotiators folks who know what they're doing and squeeze these companies to do the right thing because it's a business decision then they'll come voluntarily. This is the fourth and fifth major U.S. companies.

Novo and and Lilly are great companies but we also have Pfizer on board, AstraZeneca on board, and Serrano on board for fertility drugs. So now we're getting cancer drugs. All the big problems that are hindering America are being addressed by reducing the cost. And this goes full circle back to the government shutdown.

The democratic solution to increasing healthcare costs is to spend more taxpayer dollars on it. We should, at the same time as spending more money to make sure everyone's covered, drop the cost of care. Negotiate in a hard-nosed, tactical way, within this case, pharma, but we're going to do it with insurance companies across the board to sort of drive down the actual cost of care.

The president's a negotiator. He's a dealmaker. You know, that's how you get stuff done. You actually negotiate for what you want. And do you have any thoughts on how these ACA subsidies should move forward after they expire this year? Because the Committee for a Responsible Budget says if you do a deal and fully extend those

without any offsets, that would be the costliest way to end the shutdown ever, because a two-year extension costs $60 billion. A full-year extension costs $350 billion. The full counterproposal continuing resolution rolls back the Medicaid savings of $1.5 trillion. Republicans are never going to go for that. So do you have a thought on how you want to see this play out once these subsidies do

expire this year?

You always ask the right questions, Maria. So I spent a good part of the weekend with the White House working on exactly the answer to that question. We have lots of great ideas, but I don't want to show our cards. As the president often says, why would I telegraph you what we're going to do?

We have to have an open government. I need my top people around to be able to navigate the right solutions. We will support the American people. We always have. We want to do it in the right responsible way. If we don't, it'll implode. If we hadn't fixed Medicaid with the one big beautiful bill, it would have collapsed under the weight of its increasing expense. It was a 50 percent

increase in Medicaid spending in the last five years since the COVID pandemic started. We're at peace. There's no virus. We've got to reset, re-right-size the program with things like the Rural Health Transformation Fund where we're pouring $50 billion into rural American health care in order to fix a real problem.

But we don't want to throw money at issues. We want to actually have tactical solutions that work, and it's happening.

All right. We will be watching all of that. Dr. Oz you're doing a great job. We so appreciate your time this morning. Thank you sir. you're doing a great job. We so appreciate your time this morning. Thank you sir. I bless you. All right. Dr. Mehmet Oz joining us. Stay with us. We'll be right back.