GAO confirms large-scale, systemic fraud risk in expanded Obamacare subsidies

GAO confirms large-scale, systemic fraud risk in expanded Obamacare subsidies

Spread the love

The enhanced Obamacare subsidies that Democrats want to extend are virtually unprotected against fraud, costing taxpayers potentially billions of dollars a year, a bombshell report from the Government Accountability Office revealed Wednesday.

GAO found that in 2023, as many as 58,000 dead people received payments; as much as $21 billion was spent on overpayments, or payments to ineligible enrollees; and there were 29,000 cases of the same social security number being used in multiple plans receiving subsidies.

House Ways and Means Committee Chairman Jason Smith, R-Mo., said the report “is the smoking gun that shows how this broken system, shielded by Democrat policies, has led to the federal government shoveling tens of billions of tax dollars to insurance companies through identity fraud and caused health care costs to skyrocket for all Americans.”

Most notably, CMS’s identity proofing measures performed abysmally, with 90%-100% failure rates for GAO’s fictitious applicants.

In 2024, GAO created four fictitious applicants to obtain insurance coverage with Advance Premium Tax Credit through the ACA Marketplace. Despite all four applicants failing the online identity verification step, the Marketplace cleared their applications once they provided false identification documents.

Moreover, insurance brokers who assisted two of the fictitious applicants helped them successfully submit invalid social security numbers.

Although the Marketplace is also supposed to verify citizenship status and income, GAO’s applicants “either were not requested to provide the federal Marketplace with documentation or generally did not provide what was requested,” yet were cleared for subsidized coverage.

“In one case, we received a notice from the federal Marketplace that it confirmed the applicant’s estimated income based on documentation we submitted. However, we did not submit documentation to confirm the applicant’s income,” GAO revealed.

GAO’s retesting this past year produced essentially the same results, with 18 of the 20 fictitious applicants obtaining APTC-subsidized insurance through the Marketplace in 2025. As of September 2025, “coverage for 18 fictitious enrollees remained active,” GAO reports, costing over $10,000 per month altogether.

“While these fictitious enrollees are not generalizable to the universe of enrollees, they can suggest weaknesses in enrollment controls,” the report noted.

CMS has largely failed to implement better antifraud strategies since GAO identified fraud risks in a 2018 analysis, and has even paused certain antifraud controls. For instance, CMS only ends coverage if a deceased person is of a single-member household. For enrollees in multiple-member households, CMS does not end coverage unless households report the changes to the Marketplace themselves.

The GAO report galvanized Republican lawmakers, who for the most part have rejected Democratic demands to extend the enhanced subsidies, which will revert to pre-pandemic levels on Dec. 31.

“Democrats have the audacity to demand Republicans extend these fraud-ridden subsidies,” House Budget Chairman Jodey Arrington, R-Texas, said. “There is absolutely no justification for perpetuating these subsidies or the failed government-controlled Obamacare system Democrats are artificially propping up.”

Leave a Comment





Latest News Stories

IL GOP U.S. Senate candidate says state needs balanced representation

IL GOP U.S. Senate candidate says state needs balanced representation

By Greg Bishop | The Center SquareThe Center Square (The Center Square) – Despite having to push through a potentially crowded primary field, Republican U.S. Senate candidate Don Tracy says...
Wheat price drop brings notable Thanksgiving savings for Illinois families

Wheat price drop brings notable Thanksgiving savings for Illinois families

By Catrina Barker | The Center Square contributorThe Center Square (The Center Square) – Illinois families will see some relief at the Thanksgiving table this year, with the average cost...
Illinois lawmaker calls FDA hormone therapy reversal ‘overdue’

Illinois lawmaker calls FDA hormone therapy reversal ‘overdue’

By Catrina Barker | The Center Square contributorThe Center Square (The Center Square) – An Illinois lawmaker and practicing physician weighs said U.S. Health and Human Services Secretary Robert F....
IL Rep on congressmen trading: 'We're not going to take a pile of money to hell'

IL Rep on congressmen trading: ‘We’re not going to take a pile of money to hell’

By Jim Talamonti | The Center SquareThe Center Square (The Center Square) – An Illinois congresswoman says the public is right to be alarmed about elected officials enriching themselves through...
Illinois quick hits: Officer shot report numbers down; Thanksgiving meal costs down

Illinois quick hits: Officer shot report numbers down; Thanksgiving meal costs down

By Jim Talamonti | The Center SquareThe Center Square Officer shot report numbers down The National Fraternal Order of Police reports, through Oct. 31, 285 police officers have been shot...
WATCH: Chicago activist testifies; Quinn’s millionaire surcharge; High SNAP error rate

WATCH: Chicago activist testifies; Quinn’s millionaire surcharge; High SNAP error rate

By Greg Bishop | The Center SquareThe Center Square (The Center Square) – In today's edition of Illinois in Focus Daily, The Center Square Editor Greg Bishop shares highlights from...
GE Appliances announces $150 million partnerships

GE Appliances announces $150 million partnerships

By Andrew Rice | The Center SquareThe Center Square (The Center Square) - GE Appliances announced Thursday it is investing more than $150 million into contracts for suppliers in the...
Screenshot 2025-11-19 at 9.30.06 AM

Frankfort, Will County Partner on Wildlife Rabies Control

Will County Board Executive Committee Meeting | November 13, 2025 Article Summary: The Will County Board Executive Committee recommended approval of an intergovernmental agreement on Thursday, November 13, 2025, that allows...
Screenshot 2025-11-19 at 9.30.44 AM

Executive Committee Approves Appointments for Washington Township, Emergency Telephone Boards

Will County Board Executive Committee Meeting | November 13, 2025 Article Summary: The Will County Board Executive Committee on Thursday, November 13, 2025, recommended the approval of two key appointments, filling...
Manhattan School District 114 Logo Graphic

Manhattan D114 Schools Earn ‘Exemplary’ Status in State Report Card

Manhattan School District 114 Meeting | November 12, 2025 Article Summary:Manhattan School District 114 received outstanding results on the 2025 Illinois School Report Card, with three of its four schools...

WATCH: Dems leave hearing before minority group’s testimony on Biden border policies

By Jim Talamonti | The Center SquareThe Center Square (The Center Square) – A member of a minority grassroots Chicago organization testified before the U.S. Senate Committee on the Judiciary...
Screenshot 2025-11-19 at 9.29.37 AM

Will County Executive Committee Delays Vote on School Choice Referendum

Will County Board Executive Committee Meeting | November 13, 2025 Article Summary: The Will County Board’s Executive Committee on Thursday, November 13, 2025, postponed a decision on whether to place an...
Manhattan Township

Construction Business Permit on Sweedler Road Hits Snag Over Flood Plain Issues

Manhattan Township Meeting | September 9, 2025 Article Summary: A pre-application for a special use permit that would allow for a construction sales and service business on Sweedler Road in...
manhattan school district 114.3

Manhattan Parent Makes Emotional Plea for More Transparent School Threat Policies

Manhattan School District 114 Meeting | November 12, 2025 Article Summary:A Manhattan School District 114 parent emotionally addressed the Board of Education, describing a threat made against her third-grade son...
Chicago council committee rejects mayor’s proposed tax hikes

Chicago council committee rejects mayor’s proposed tax hikes

By Jim Talamonti | The Center SquareThe Center Square (The Center Square) – The Chicago City Council Committee on Finance has rejected a package of higher taxes proposed by Mayor...