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Home » News » Featured » How Maine Became Ground Zero in the National Medicaid Fraud Scandal — And Why Augusta Spent Three Years Pretending It Wasn’t Happening
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How Maine Became Ground Zero in the National Medicaid Fraud Scandal — And Why Augusta Spent Three Years Pretending It Wasn’t Happening

Maine's Medicaid fraud catastrophe is only getting worse. Here's a look at how we got here, the facts on the ground, and where we're going.
Steve RobinsonBy Steve RobinsonApril 27, 2026No Comments29 Mins Read
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For eight years, the evidence has been piling up in plain view: MaineCare, the state’s $4-billion-and-growing Medicaid behemoth, has become the most defrauded welfare program in Maine’s history. Audits. Whistleblowers. Federal claims data. Federal demand letters. Secret directives ordering state employees not to talk to the U.S. Department of Justice. Internal emails admitting the goal of state government is to dodge a congressional subpoena. Ghost office addresses billing millions for services that auditors cannot confirm took place. Reimbursement rates running at multiples of the national average for the same services rendered in every other state. Investigative reports coming from — nearly exclusively, The Maine Wire — tell an irrefutable story of mismanagement, bad government, and corruption.

For most of that time, the people running Maine — Gov. Janet Mills (D), her Attorney General Aaron Frey (D), her Department of Health and Human Services Commissioners Jeanne Lambrew and Sarah Gagne-Holmes, and the Democratic majority in the Legislature — pretended there was nothing to see. Or else they dismissed well-founded, credible reports of systemic welfare fraud as partisan talking points or racism.

That pretense is over. It ended on March 16, 2026, when Republican President Donald Trump signed an executive order establishing the Task Force to Eliminate Fraud and explicitly named Maine as one of six states where, in the words of the order itself, “strong reason” exists to believe “similar vulnerabilities” exist to those that produced the multibillion-dollar Feeding Our Future scandal in Minnesota. It ended in January when Health and Human Services Secretary Robert Kennedy, Jr. ordered the unprecedented release of claims-level Medicaid payment data, allowing journalists to probe for themselves how America’s largest welfare program functions. It ended on Feb. 27, 2026, when the Centers for Medicare & Medicaid Services (CMS) denied Mills’ quiet request for a 30-day extension to comply with a federal records demand on Maine’s autism billing — just one of the myriad programs where fraud indicators are multiplying on a daily basis. It ended in April 2026 when Mills’ own Department of Health and Human Services (DHHS) — without a press release, without a press conference, without notifying the Legislature — froze new provider enrollments in the four MaineCare waiver programs at the center of fraud allegations, and a few days later began withholding payments to providers because the program is, again, out of money.

A spokeswoman from DHHS downplayed the drastic stop-payment orders imposed on Maine’s Medicaid providers.

“As noted in the Governor’s supplemental budget proposal, DHHS requested $62 million to fund MaineCare to meet needs in this current fiscal year, which ends June 30, 2026. Without those funds before June 30, we will have a shortfall. Although the supplemental budget that was recently signed into law included the $62 million to fund the MaineCare shortfall, the funds are not available until SFY 2027. Therefore, the Department will need to cap certain MaineCare payments starting May 13,” the spokesperson said in a statement to The Robinson Report.

That $62 million follows the more than $118 million in new welfare spending the Mills Administration demanded last year, when the Department of Administrative and Financial Services (DAFS) notified state lawmakers that MaineCare was, once again, running out of money. In other words, MaineCare — a program that is mostly paid for with federal matching dollars — has come up $180 million short in 2025-2026, a spending problem that has caused Democratic lawmakers to raise taxes on working Mainers rather than investigate why the state’s largest program continues to bust budgets.

Democratic lawmakers and Mills admin apparatchiks have avoided investigating the causes of the habitual Medicaid cost overruns because such an investigation would lead to some uncomfortable answers about bureaucratic incompetence, welfare dependency, and, most of all, fraud. Not just the kind of fraud where people who shouldn’t be on welfare take advantage of the system. The kind of fraud where organized groups systematically bilk Medicaid through sophisticated, industrial scale schemes. That’s the kind of fraud Maine is dealing with now, and that’s the explanation for why the State House is constantly scrounging around our wallets and purses for more tax revenue to feed the MaineCare monster.

To understand why Maine ended up here, you have to start with the program itself. MaineCare was a moderately sized state Medicaid operation when Janet Mills took office in January 2019. Her first executive order — signed on Jan. 3, hours after she was sworn in — implemented Medicaid expansion, the unprecedented welfare state expansion that was the foundation of the Affordable Care Act, aka ObamaCare. Her predecessor, Republican Gov. Paul LePage, had refused to expand Medicaid multiple times, arguing that it would increase the state’s deficits, breed government dependency, undermine Maine’s hospitals, and turn Maine into a magnet for welfare cases. He was right. That single act by Mills added approximately 100,000 new enrollees to MaineCare, the overwhelming majority of them childless, able-bodied adults. In other words, healthy people with no families who could be working.

By the fall of 2019, internal DHHS data showed that adults without children represented 81 percent of expansion enrollees, and roughly one-third of all enrollees were between the ages of 19 and 29. In 2022, Mills and Democratic lawmakers expanded MaineCare a second time, adding a broader class of noncitizens to the program. That expansion came as waves of Central Africans — most of them purporting to be asylum seekers — inexplicably began arriving in Portland. In 2023, MaineCare eligibility for children was further expanded to family incomes up to 305 percent of the federal poverty level. The result was yet another enrollment explosion.

From 2015 to 2025, Maine’s population remained virtually unchanged. Yet, according to the Kaiser Family Foundation, Maine’s Medicaid enrollment surged from ~278,000 in 2015 to ~396,000-400,000 in 2025. MaineCare grew by 50 percent between 2019 and 2023. About 30 percent of all Mainers, and more than half of all Maine children, are on Medicaid. MaineCare now consumes roughly 32 percent of Maine’s total state budget. The program drew more than $1 billion from the state general fund for the first time in 2024 and grew to $1.4 billion in 2025, even though enrollment had begun to drop.

For comparison, New Hampshire saw Medicaid enrollment grow from ~189,000 in 2015 (or roughly 14 percent) to more than 256,000 in 2022 (or 28 percent). For the Granite State, however, the COVID Era peak was an anomaly, not a new status quo, and the state’s Medicaid population dropped to ~181,000 in 2025, or about 12.8 percent. That means that while Maine’s welfare dependency was growing, New Hampshire’s welfare caseload actually shrunk.

In a Nov. 2019 op-ed in the Portland newspaper, Mills assured Mainers that expansion “spending remains within projections.” That sentence has aged poorly. A 2018 Foundation for Government Accountability study of states that had expanded Medicaid found that, on average, expansion costs ran 157 percent above the state projections used to sell the policy. Some states blew past 200 percent of projection. The pandemic and the federal government’s emergency increase in Medicaid match rates masked the true cost trajectory in Maine for several years. As LePage said during his ill-fated campaign against Mills in 2022: A lot of money masks a lot of problems.

He was right, and that mask has come off. Now the bill is coming due.

The MaineCare Budget Buster

Twice in the last 13 months, the Mills administration has been blindsided by what it has described, with apparently genuine surprise, as unexpectedly high MaineCare costs.

The first time was in Jan. 2025. Mills’ budget office advised the incoming 132nd Legislature that it had to address a $450 million General Fund shortfall and an immediate $118 million MaineCare deficit for the current fiscal year. Senate Republicans refused to deliver the two-thirds emergency-passage vote without structural MaineCare reforms. That standoff dragged on for months. DHHS began “capping weekly cycles” to ration the dwindling cash. Hospital administrators warned of a return to the days of the LePage-era $183.5 million state debt to 39 Maine hospitals. Anyone who’d been listening to LePage’s warnings about Medicaid expansion and its consequences would not have been surprised.

The second Medicaid cost-overrun happened just this month. Mills’ supplemental budget request for fiscal year 2027 included $141 million in additional MaineCare funding “to account for rising medical costs and changes in the federal match rate” — alongside another $24 million bump to align with federal matching changes. Then, in April, DHHS quietly began withholding pharmacy claims again, citing the same essential problem: the cupboard is bare until the next fiscal year begins. Translation: Maine doesn’t have the money to pay its bills.

Twice in just over a year, in other words, the people in charge of administering MaineCare have been caught flat-footed by costs they apparently never saw coming. That is a striking admission to make about a program where Michelle Probert, the MaineCare director, told the Portland newspaper that the COVID-era enhanced federal match “made states not as aware, especially outside of Medicaid and Department of Health and Human Services, not as aware of the true costs of increases associated with higher enrollment.”

The state agency responsible for forecasting MaineCare costs has explained that it was not aware of the costs of the program it administers.

What a stunning admission.


Once you start looking at what MaineCare actually spends money on, the surprise stops being surprising.

Federal Medicaid claims data layered against the National Provider Index — the dataset CMS released in early 2026 — shows that from 2018 through 2024, Maine spent $9.49 billion on Medicaid at in-state providers. The cost per claim rose 41 percent over that period, from $90.78 to $128.21, far outpacing inflation. Total claims volume grew only 10 percent. Maine isn’t paying for more care. It is paying much more for the same care. Mainers aren’t getting more or better health care. We’re paying for a multiplicity of new businesses created for the express purpose of milking the MaineCare ask-no-questions payment network.

Service-by-service, the picture gets worse. Maine spends 5.4 times the national average per claim on substance abuse treatment drugs like methadone and Suboxone. The same medication-assisted treatment delivered in the same federally regulated framework is more than five times cheaper in most other states. Maine’s residential care program — group homes for disabled adults — pays an average claim of $1,671 versus $482.04 nationwide. Section 21 autism group homes are billing at multiples of national averages. Section 29 in-home autism support services — the program flagged in a CMS audit Mills dismissed as a political attack — have followed the same trajectory. Section 18, traumatic brain injury services, has its own cluster of providers running at outlier rates.

Virtually every service Medicaid covers costs more in Maine than in every other state. The explanation for this cost discrepancy is, in some cases, complex. But in other cases — like when Medicaid fraud cartels are systematically stealing from taxpayers — the answers are a lot clearer.


The single most striking case study is Paradise Residential Services LLC, the Portland-area autism residential-care company DHHS finally deauthorized on March 9, 2026. Federal records show Paradise was incorporated on Jan. 31, 2020, with $75,000 in startup capital, for the express purpose of operating Section 21 group homes. It billed $2,126,503 in 2022, serving 12 clients. By 2024 it was billing $7,942,326 across 237 clients. Total billings over three years reached $15,856,478 — a 273.5 percent increase. All of this was known to the state of Maine; however, the public only found out thanks to the release of the federal data. Although Maine’s taxpayer-funded media outlets still haven’t found out how to locate that data and analyze it, we have.

Paradise billed the T2016 habilitation code — the standard per-diem code used by every group home in the country — at between 2.07 and 2.09 times the national average every single year. It ranked in the top 5 percent of all U.S. autism group home operators by cost per claim in each year of available data. The national average for T2016 is $16,106 per client per month. Paradise averaged between $33,372 and $33,742. Per-beneficiary monthly billing topped $33,000, equating to nearly $400,000 per patient per year. The odds of this kind of billing happening at an honest Medicaid provider are equivalent to the odds that Graham Platner only learned about his Nazi tattoo a few weeks ago.

The Paradise principals — CEO Jocelyne Ininahazwe and CFO Juste Arakaza, both Central African migrants — built the company using primarily Central African migrant workers. Their country of origin matters only in so far as their employees are mostly non-English speaking “Direct Support Professionals” who are impeded in their ability to provide care for disabled Mainers but an utter inability to communicate. Non-English speaking DSPs can’t read behavioral plans or dietary plans. They can’t assess medical emergencies or talk with first responders if there’s a 911 call. All they can do is provide a warm body within a Section 21 home that allows companies like Paradise to bill $25,000-$35,000 per month for “health care.”

Paradise Residential Services, like more than a dozen of Maine’s leading autism care providers, exhibits signs of complex corporate structures that allow the principals to maximize their personal revenue from MaineCare. On Nov. 12, 2024, the same year Paradise billed nearly $8 million to MaineCare, Arakaza transferred three properties to a new entity called Ninta Service LLC. When reporters visited the Paradise office in December 2025, a Mercedes-Benz G-Wagon sat in the parking lot bearing the vanity license plate with the name of Ininahazwe’s son. When reporters returned to attempt an interview with Ininahazwe in March 2026, she drove off in a Mercedes E300.

Paradise is one company. The Section 21 ecosystem is full of them. But if you’re looking for an explanation for MaineCare’s continual cost overruns, you might start by counting the luxury cars piling up at the brand new homes of residential care executives.


The Lewiston-based Gateway Community Services case is the one most Maine readers know — if they know any of this at all — and it remains the gravitational center of the broader investigation. Gateway was founded in 2014 by a Somali-American refugee named Abdullahi Ali. In March 2025, a Notice of Violation surfaced showing DHHS had previously audited Gateway and found the company had overbilled MaineCare by hundreds of thousands of dollars during 2015–2017 — a debt that, as of 2022, had not been repaid. Two months later, a former Gateway billing specialist named Christopher Bernardini went on the record with The Robinson Report alleging that Gateway leaders had been systematically inflating Medicaid claims at Ali’s direction for at least seven years. Other employees said they personally witnessed the forging of Medicaid billing records.

Somali-American Refugee's Medicaid Firm Submitted Fraudulent MaineCare  Claims for Years, Former Employees Allege - The Maine Wire

“Well, this is, this is borderline fraud,” Bernardini said he told supervisors at the time. “I told them a long time ago, this is, this is borderline. I don’t understand how they’ve gotten away with it for as long as they have.”

In Bernardini’s account, Gateway leaders falsified eligibility records, forged client signatures and billed for services that were never delivered. In 2024, long before he went public with his allegations, Bernardini had filed whistleblower complaints with the U.S. Department of Homeland Security (DHS) and the Maine Office of the State Auditor. Both complaints were ignored.

Ali, while running up roughly $5 million per year in MaineCare reimbursements, also collected nearly $700,000 under the federal Paycheck Protection Program. He used a chunk of it to buy a million-dollar house at 58 Hardy Road in Falmouth. He campaigned for elected office in Jubaland — a region of Somalia — and told supporters on camera that he was financing Somali paramilitary groups. In other words, Maine’s Medicaid dollars were underwriting civil war arms deals and regime change ops in Jubaland.

Homeland Security Investigations agents appear to be probing multiple Lewiston locations associated with Gateway and its former deputies — including state Rep. Deqa Dhalac (D-South Portland), Gateway’s former assistant executive director, and state Rep. Yusuf Yusuf (D-Portland), whose own MaineCare-billing company, Care for Everyone, shares an address with a Somali-run home health agency and a foreign money transfer station.

Dhalac is now ensnared in a House Oversight Committee inquiry led by Chairman Rep. James Comer (R-Ky.), which has formally requested Treasury anti-money-laundering records connected to Gateway, Ali and Dhalac. That probe might have something to do with Dhalac’s decision to not seek re-election to the State Legislature — and Ali’s decision to avoid setting foot on U.S. soil. Comer has tied Maine’s situation to Minnesota’s, where federal prosecutors estimate fraud “well in excess of $1 billion” and warn that “half or more” of $18 billion in federal Medicaid claims paid to 14 Minnesota high-risk programs since 2018 may have been fraudulent. —

Gateway is far from alone. The pattern is consistent: a particular kind of MaineCare provider, almost always launched after 2020, almost always run out of a residential or shared address (many of them based in public housing), almost always billing for services that auditors cannot verify took place. Those services include “home health care” agencies, where Personal Support Specialists assist MaineCare enrollees with home chores, as well as residential care programs, where MaineCare enrollees live in subsidized housing with 24/7 Direct Support Professionals.

Consider Affinity Homecare, a Somali-run agency that received $1,157,503 in MaineCare payouts from 2020 to 2024. DHHS auditors tried to recoup nearly $450,000 after they could find no documentation that the services Affinity billed for had actually taken place. When auditors physically visited Affinity’s listed addresses, they found nothing at either location to suggest the company even existed. Rep. Yusuf Yusuf, a former Gateway employee, has his own Medicaid biz, Care for Everyone, which collected $1,212,852 in MaineCare cash from 2020 through 2024. Yusuf’s agency shared an address with Affinity. Remarkably, the 203 Anderson St. address where Yusuf’s MaineCare business is now headquartered is the same address as a foreign money transfer service, Dahabshiil — the preferred wire service of the Central Bank of Somalia.

Yusuf’s not the only Somali migrant making use of 203 Anderson St. in Portland. There are five home-care businesses — Holding Hands Home Health Care, Maine Connect Care, ACME Care, Engility Enterprises and Morning Light Care — registered in the space, alongside the Dahabshiil. Those businesses have collectively received $13,774,554 in MaineCare payments between 2019 and 2024 from one shared address.

Across town at 75 Bishop St., there’s a large office complex filled with one-room suites that serve as ghost offices for a host of lucrative MaineCare billing operations. Consider 5 Stars Home Health Care, run by a 25-year-old named Mostafa Alahmedi, whom DHHS auditors found had overbilled MaineCare by nearly $400,000 — and who walked away from the program after the agency stopped paying him in Feb. 2025. There is no public indication he was ever criminally investigated. He is reportedly now in Turkmenistan. Several other home care agencies — all of them bearing the same suspicious indicators as 5 Stars — continue to operate out of the MaineCare hive on Bishop St.

The federal OIG has traced the multitude of Medicaid failures to a decade-long oversight vacuum: the state has not conducted a statewide post-payment review of these providers since the child autism program began in 2010. Notably, the Mills administration didn’t even bother to rebut the audit’s findings; Maine officials “potentially concurred” with the demand to refund the $28.7 million federal share, while admitting they lacked any basis to respond to the audit because there had been no oversight of the program.

Maine’s own State Auditor — appointed by Democratic lawmakers — confirmed the picture from the other direction. On March 26, 2026, the auditor reported that MaineCare’s Program Integrity Unit “may not provide adequate monitoring of all Medicaid services.” That was not a Trump administration finding. That was Augusta auditing Augusta. And the finding deserves an award for the Understatement of the Year.


The Ongoing Cover-Up

The most damning material in this entire scandal is what Mills’ own administration was doing in private while she insisted in public that there was nothing to investigate.

On Jan. 10, 2025 — ten days before President Trump was inaugurated — then-Attorney General Aaron Frey issued what amounted to a secret directive to DHHS employees instructing them not to cooperate with U.S. Department of Justice attorneys. Inquiries from federal prosecutors were to be referred up the chain to supervisors and state counsel. The directive was issued before the new administration had taken any action against Maine. It was issued before any of the federal Medicaid investigations had begun. The state’s chief law enforcement officer, in other words, instructed the welfare agency under his counsel’s authority not to talk to federal prosecutors — the very prosecutors who would shortly be examining whether MaineCare had been defrauded of hundreds of millions of dollars.

Eight months later, in September 2025, DHHS Commissioner Sara Gagné-Holmes sent an email to top department officials — including Office of Family Independence Director Ian Yaffe and Deputy Commissioner Bethany Hamm — telling them DHHS needed to “check in” with the governor’s office “before we produce any data” in response to a House Oversight Committee records request on MaineCare spending. In the same email chain, obtained under the Maine Freedom of Access Act, Gagné-Holmes wrote, in her own words, that “the goal here is to avoid a congressional subpoena.”

Read that again. Not “the goal here is transparency.” Not “the goal here is to cooperate with federal oversight of a federally funded program.” The goal here is to avoid a congressional subpoena.

The congressional inquiry Gagné-Holmes was so anxious to dodge is itself worth understanding in full. On Sept. 3, 2025, Comer sent letters to eight Democratic governors — Mills along with Govs. Gavin Newsom of California, Jared Polis of Colorado, JB Pritzker of Illinois, Kathy Hochul of New York, Tina Kotek of Oregon, Tim Walz of Minnesota and Bob Ferguson of Washington — opening a formal investigation into whether any of those states had improperly used federal Medicaid funds to cover noncitizens, including illegal immigrants. If a state were to mix those buckets — to bill the federal government for illegal-alien healthcare costs that should have been paid entirely with state dollars — that state could be on the hook for hundreds of millions of dollars in illegal reimbursements, with potential criminal exposure for the officials who authorized the scheme.

Comer’s letter to Mills and Gagné-Holmes requested eight categories of information: the names of all programs providing health coverage and other services to “illegal aliens,” verification procedures for immigration status, the number of people denied coverage or shifted to Emergency Medicaid because of immigration status, and a complete list of every Medicaid or Emergency Medicaid procedure provided to an illegal alien with associated costs, covering January 2019 to the present.

The response was led inside DHHS by MaineCare Director Michelle Probert, OFI Director Yaffe and Assistant Attorney General Brendan Kreckel. After the flurry of internal panic — including Gagné-Holmes’ subpoena-avoidance email — the Mills administration certified, under penalty of perjury, that Maine had spent less than $15 million on Emergency Medicaid services for illegal aliens from 2019 through 2025.

That figure was reached only after the administration narrowed the scope of responsive records as tightly as it could without committing an outright crime. Congress had asked for all Medicaid and Emergency Medicaid procedures and benefits provided to “illegal aliens” or individuals with “unsatisfactory immigration status.” A reasonable reader would interpret that as money MaineCare spent on people not eligible for federally reimbursed Medicaid — that is, anyone who is neither a U.S. citizen nor a naturalized citizen. In Maine, all noncitizens under 21 and all pregnant women, regardless of immigration status, receive the same full Medicaid benefits as U.S. citizens. By excluding CHIP and the state’s Cub Care program from the response, by adopting the most cramped possible reading of “unsatisfactory immigration status,” by refusing even to use the term “illegal alien” in correspondence, the Mills administration produced a number that was technically defensible inside its lawyers’ four corners but bore no relationship to what Comer had actually asked for.

The response borders on perjury. It was signed under oath. It was crafted to mislead. The administration knew what Congress was asking. The administration chose, as a matter of strategy, not to answer the question. The House Oversight Committee is well aware of the strategy the Mills admin pursued, in part because of Freedom of Access Act documents obtained by The Robinson Report.

Taken together — Frey’s January 2025 order not to talk to DOJ, the September 2025 panic to dodge a subpoena, the cramped November-December 2025 response to Comer that minimized the noncitizen-spending figure to a fraction of its actual scope — the Mills administration’s pattern is unmistakable. It is the conduct of an administration that knows what is in its files.

In public, Mills has been pure defiance. On March 6, 2026, she issued a statement deriding Oz as a “TV Doctor” and flatly rejecting allegations of Medicaid fraud. She vowed to fight the Trump administration in court if it tried to halt Medicaid payments to Maine. “Maine is fighting fraud and we will continue to fight fraud,” she declared. “Maine will not be intimidated by the threats of a President who is using allegations of fraud as a pretext to hurt people. We will fight back.”

Then, in April 2026, Mills’ DHHS — quietly, by terse internal email — froze new provider enrollments in MaineCare Sections 18, 20, 21 and 29: the four Home and Community Based Services waiver programs at the center of the federal probe. “Effective April 13, 2026, the Office of Aging and Disability Services (OADS) is temporarily pausing acceptance and review of initial applications from entities seeking to become OADS-approved waiver providers under MaineCare Benefits Manual (MBM) Sections 18, 20, 21, and 29,” the email read. The agency’s stated rationale was bureaucratic: “limited staff resources,” “timely and consistent review.” The actual signal was unmistakable. Behind the scenes, her own agency had just admitted that the situation was serious enough to shut the door. Both things cannot be true at the same time. Either the fraud is a political invention, in which case there is no reason to freeze enrollment, or the fraud is real, in which case the political invention is the denial — a lie.

A few days later, DHHS quietly began withholding payments to MaineCare providers until the next fiscal year — the second time in 13 months her department has played that game. DHHS staffers have told the Legislature that the welfare agency has referred only one or two cases of Medicaid fraud for criminal prosecution — out of a $4 billion program in which federal investigators have identified hundreds of high-risk providers.


The defenders of the status quo will say, as they have said for three years, that all of this is a partisan attack — that Trump, Oz and Vance are weaponizing Medicaid oversight to hurt a blue state and a Democratic governor with U.S. Senate ambitions. So let’s talk about what Maine Republicans have actually proposed.

In February 2025, with MaineCare facing the $118 million in-year shortfall, Senate Republicans made it clear they would not vote to bail out the program without structural reform. Sen. Jeff Timberlake, Assistant Senate Republican Leader Matt Harrington (R-York) and Rep. Jack Ducharme (R-Madison) put forward a series of amendments: instruct DHHS to seek a federal waiver freezing new MaineCare enrollment for able-bodied, childless adults and to gradually reduce that population by 10 percent before capping it; institute a work or community-engagement requirement for non-disabled, dependent-free MaineCare recipients aged 19 to 64; conduct a full review of MaineCare for fraud, waste and abuse.

“We are not going to bail out a welfare program that is failing,” Harrington said on the floor.

Senate Minority Leader Trey Stewart (R-Presque Isle) put it in writing: “It’s unfortunate that Democrats want to continue to ignore our concerns surrounding the core policy issues that precipitated the MaineCare shortfall. I have made it very clear to my Democrat colleagues that without substantive welfare reform, there would not be enough votes from my caucus to ensure two-thirds passage of the budget in the Senate.”

Senate President Mattie Daughtry (D-Brunswick) eventually offered an amendment that incorporated some of those Republican demands — the 12-month General Assistance limit, cost-of-living adjustments for direct-care workers and a fraud-and-waste review of MaineCare. The compromise initially passed both chambers with bipartisan support. Then it fell apart. House Minority Leader Billy Bob Faulkingham (R-Winter Harbor) and most Senate Republicans concluded the package did not go far enough on structural reform; only Sens. Rick Bennett of Oxford and Marianne Moore of Washington crossed over on enactment. The bill died. Daughtry accused Republicans of “moving the goalpost.” Mills called the failure “a grave disappointment.” Democrats then pushed through a two-year budget without Republican support, stripped of the MaineCare review and the General Assistance limits, and continued state government on auto-pilot.

When the funding gap reappeared in May 2025, Democrats accepted a late-filed emergency bill, LD 1948, to release the MaineCare money sooner. “This bill before us here is just the blank check part without the other reforms that we had agreed to,” Faulkingham said before the vote. The blank check, in other words, without any of the safeguards.

The pattern is clear. Republicans have used every leverage point available to them in a body where they hold neither chamber: budget hostage-taking, floor amendments, public statements, on-the-record demands for investigation. They were the ones who first called publicly for an investigation into Bernardini’s allegations against Gateway. They were the ones who filed amendments instructing DHHS to seek federal waivers for work requirements and enrollment caps in MaineCare expansion. In November 2025, Republicans on the Legislature’s Government Oversight Committee filed a formal request to investigate alleged fraud against MaineCare vendors. Democrats blocked or watered down every one of those measures.

And the Democratic majority did more than block. The 2026 supplemental budget Mills signed dumped another $33.8 million into Section 21 — the autism group-home program — and another $6.8 million into Section 29, even as the administration was freezing new provider enrollment in those same programs because of fraud concerns. The Legislature also transferred $53 million to a new MaineCare Stabilization Fund to offset future shortfalls. That same supplemental contained a provision — buried in the abortion section of the bill, of all places — directing Maine to substitute state dollars for federal Medicaid matching funds any time the federal government restricts a specific provider. The provision is written broadly enough to force Maine taxpayers to cover 100 percent of payments to any MaineCare provider that CMS disqualifies for fraud. Read that sentence twice. Maine Democrats voted to make state taxpayers backstop the bill on Medicaid providers the federal government has deemed too fraudulent to receive federal money.


The federal posture has shifted decisively. Maine’s deflection strategy is no longer working.

On March 16, 2026, President Trump signed Executive Order 14395, “Establishing the Task Force to Eliminate Fraud,” chaired by Vice President J.D. Vance — whom the president would shortly nickname the “fraud czar.” The executive order specifically names Maine, alongside California, Illinois, New York, Minnesota and Colorado, as states where “strong reason” exists to believe similar Medicaid-fraud vulnerabilities exist. It directs federal agencies, in some cases, to “proactively pause” funding until controls are in place. CMS has already withheld $259.5 million from Minnesota and suspended more than 200 hospice and home-health providers in California.

What the federal task force will find in Maine is, by any honest measure, the largest welfare fraud scandal in Maine history. It involves more than half a dozen state lawmakers, political insiders, well connected politicos, including gatekeepers in the Somali community. Hundreds of millions of dollars in suspect billing. Multiple federal investigations. A sitting governor who has spent two years denying what her own bureaucracy was privately panicking about. A program that pays five times the national average for the same opioid medication, three times the national average for the same residential care, twice the national average for the same autism group-home services. A program whose costs the people running it claim to have been twice surprised by inside a single year. A program that is forced, twice in 13 months, to stop paying its bills.

The Trump administration’s National Fraud Enforcement Division at DOJ, led by Assistant Attorney General Colin McDonald, was sworn in on April 1, 2026. The Task Force to Eliminate Fraud held its first meeting on March 27. CMS has Maine’s incomplete autism-billing response in hand. The House Oversight Committee has not concluded its inquiry — and the under-oath response Mills’ commissioner produced will be examined by federal investigators with a great deal more leverage than the press has had. Federal agents have already searched multiple Lewiston locations connected to Gateway, Ali, Dhalac and other Somali-run agencies. Property is being liquidated. Principals are leaving the country. Each passing week makes Mills’ “TV Doctor” line look worse.

Three years ago, the official line was that there was no Medicaid fraud problem in Maine worth talking about. The official line is now that there might be a problem, but not one connected to anyone who matters in Maine Democratic politics, and certainly not one that justifies federal scrutiny. The official line is wrong. It has been wrong for three years. The federal government, the state auditor, DHHS’ own actions and the Mills admin’s own private emails now agree that it has been wrong. Mainers paid for that wrongness — in dollars, in services not delivered to vulnerable people who actually needed them, and in a political culture in which “investigate this” has been treated as a partisan slur rather than a duty.

The reckoning is here. It is overdue. And Mainers of good conscience should celebrate efforts to rid the state of fraud and end the culture of corruption that has metastasized these paste eight years.

Previous ArticleMaine’s Congressional Delegation Reaches Out to USPS Over Back-Balance Owed to Island Contractor
Steve Robinson
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Steve Robinson is the Editor-in-Chief of The Maine Wire. ‪He can be reached by email at [email protected].

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