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

Trump signs executive order to improve foster care

Trump signs executive order to improve foster care

By Morgan SweeneyThe Center Square In line with First Lady Melania Trump’s efforts to improve the foster care system, the president signed an executive order Thursday to better support foster...
Hegseth announces Operation Southern Spear, targeting narco-terrorists

Hegseth announces Operation Southern Spear, targeting narco-terrorists

By Sarah Roderick-FitchThe Center Square Operation Southern Spear, the new title for the Trump administration’s targeting of narco-terrorists in and around Latin America, was announced Thursday by Secretary of War...
Justice Department accuses California of racial gerrymandering in redistricting plan

Justice Department accuses California of racial gerrymandering in redistricting plan

By Brett RowlandThe Center Square The U.S. Department of Justice sued California officials Thursday over the state's redistricting plan, which could help Democrats pick up additional seats in Congress. The...
Illinois quick hits: WARN Act reporting shows 1,600 job losses in October

Illinois quick hits: WARN Act reporting shows 1,600 job losses in October

By Jim Talamonti | The Center SquareThe Center Square WARN Act reporting shows 1,600 job losses in October The Illinois Worker Adjustment and Retraining Notification (WARN) Act for October reports...
Pritzker, alders oppose Chicago tax plans, property tax hike could be next

Pritzker, alders oppose Chicago tax plans, property tax hike could be next

By Jim Talamonti | The Center SquareThe Center Square (The Center Square) – As the Chicago City Council considers 2026 budget measures, Mayor Brandon Johnson’s proposed tax hikes continue to...
State Department designates European Antifa groups foreign terror organizations

State Department designates European Antifa groups foreign terror organizations

By Sarah Roderick-FitchThe Center Square The U.S. State Department officially designated four foreign Antifa groups as foreign terrorist organizations, nearly two months after President Donald Trump designated Antifa a domestic...
NetChoice scores legal win in social media warning lawsuit

NetChoice scores legal win in social media warning lawsuit

By Elyse ApelThe Center Square A U.S. District Court recently granted a preliminary injunction against a new Colorado law that would require social media platforms to regularly send pop-up notifications...
Union Pacific–Norfolk Southern merger draws more support as critics push back

Union Pacific–Norfolk Southern merger draws more support as critics push back

By Tom JoyceThe Center Square Support is growing for the proposed merger between Union Pacific and Norfolk Southern as federal regulators continue reviewing what would become the first transcontinental freight...
TSA agents who worked throughout shutdown to receive $10,000 bonus

TSA agents who worked throughout shutdown to receive $10,000 bonus

By Thérèse BoudreauxThe Center Square The Department of Homeland Security will issue $10,000 bonus checks to Transportation Security Administration (TSA) agents who demonstrated “exemplary” behavior and work attendance during the...
Boeing to pay $36M to family of Indian woman killed in Ethiopia Air crash

Boeing to pay $36M to family of Indian woman killed in Ethiopia Air crash

By Jonathan Bilyk | Legal NewslineThe Center Square The family of a woman from India who died in a 2019 airliner crash could receive nearly $35 million from Boeing, under...
Pro-life org invests $80M into 2026 midterms, will reach 10.5M voters

Pro-life org invests $80M into 2026 midterms, will reach 10.5M voters

By Tate MillerThe Center Square Susan B. Anthony Pro-Life America says it will reach 10.5 million voters by its newly announced investment of $80 million into the 2026 midterm election,...
Refilling Strategic Petroleum Reserve begins

Refilling Strategic Petroleum Reserve begins

By Alton WallaceThe Center Square About 1 million barrels of crude oil that will go toward replenishing the nation’s Strategic Petroleum Reserve have been purchased, the U.S. Department of Energy...

WATCH: Lawmakers call out Pritzker for lack of transparency with budget cuts

By Jim Talamonti | The Center SquareThe Center Square (The Center Square) – Illinois lawmakers say they are not getting information from Gov. J.B. Pritzker or state agencies about the...
Report: Barriers to social mobility largely manmade

Report: Barriers to social mobility largely manmade

By Tate MillerThe Center Square Authors of a new report on social mobility across the 50 states said that barriers to social mobility are largely “man-made” and can be solved...
Fetterman hospitalized for heart episode

Fetterman hospitalized for heart episode

By Christen SmithThe Center Square Pennsylvania Democratic U.S. Sen. John Fetterman remains under observation at a Pittsburgh-area hospital following a heart episode early Thursday. The senator’s spokesman posted to his...