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

Joliet-Junior-college.-Graphic-Logo.2

JJC Advances ERP Modernization with New Vendor and Two-Year Budget

Joliet Junior College Board of Trustees Meeting | October 15, 2025 Article SummaryJoliet Junior College is entering the next phase of its Enterprise Resource Planning (ERP) system overhaul, with the...
Screenshot 2025-11-06 at 4.17.02 PM

Will County Committee Shapes 2026 Legislative Agendas on Housing, Energy, and Health

Meeting Summary and Briefs: Will County Legislative Committee for November 4, 2025 Article Summary: The Will County Legislative Committee advanced key priorities for its 2026 state and federal legislative agendas, focusing...
Joliet-Junior-college.-Graphic-Logo.4

JJC Authorizes Land Buy for Grundy County Expansion, Secures Site in Morris

Joliet Junior College Board of Trustees Meeting | October 15, 2025 Article SummaryThe Joliet Junior College (JJC) Board of Trustees has authorized negotiations for a land acquisition to build a...
will county board graphic

Commission Grants Green Garden Solar Farm Project Variance Extension

Will County Planning and Zoning Commission Meeting | November 4, 2025 Article Summary: The Will County Planning and Zoning Commission granted a 180-day extension for two variances related to a commercial...
Untitled design - 1

Manhattan-Elwood Library Board Approves Annual Tax Levy

Manhattan-Elwood Public Library District Board Meeting | September 2025 Article SummaryThe Manhattan-Elwood Public Library District Board of Trustees unanimously approved its 2025 tax levy following a public hearing on September...
Screenshot 2025-11-05 at 3.23.42 PM

Manhattan Adopts Downtown Design Guidelines to Unify and Revitalize Village Center

Manhattan Village Board Meeting | November 4, 2025 Article Summary: The Manhattan Village Board on Tuesday, November 4, 2025, unanimously approved a new set of Downtown Design Guidelines aimed at...
Will Dial-A-Ride Service

Will County Committee Advances Phased Takeover of Central Will Dial-A-Ride Service

Will County Public Works & Transportation Committee Meeting | November 2025 Article Summary: The Will County Board approved a five-year plan to consolidate the Central Will Dial-A-Ride service into its...
Screenshot 2025-11-05 at 3.23.31 PM

Manhattan Grapples with Route 52 Safety After Tragedy, Demands Action from IDOT

Manhattan Village Board Meeting | November 4, 2025 Article Summary: Following a recent tragedy, the Manhattan Village Board on Tuesday, November 4, 2025, held an extensive public discussion on the...
manhattan park district graphic.2

Manhattan Park District Ratifies Emergency Purchase of Bucket Truck for $36,500

Manhattan Park Board Meeting | September 2025 Article Summary: The Manhattan Park Board has unanimously ratified the emergency purchase of a used 2012 Ram 5500 bucket truck for $36,500. The board...
Meeting Briefs

Meeting Summary and Briefs: Will County Planning and Zoning Commission for October 21, 2025

Will County Planning and Zoning Commission Meeting | October 21, 2025 The Will County Planning and Zoning Commission on Tuesday, October 21, 2025, tackled several high-profile land use issues, recommending...
Meeting Briefs

Meeting Summary and Briefs: Will County Board Finance Committee for October 21, 2025

Will County Board Finance Committee Meeting | October 21, 2025 A contentious debate over a looming $8.9 million budget shortfall dominated the Will County Board Finance Committee meeting on Tuesday....
Meeting Briefs

Meeting Summary and Briefs: Manhattan Fire Protection District for September 15, 2025

Manhattan Fire Protection District Meeting | September 15, 2025 The Manhattan Fire Protection District Board of Trustees took a major step toward building a new fire station at its meeting...
Screenshot 2025-10-25 at 12.43.17 PM

Future of Will County’s Cannabis Fund Debated Amid Budget Shortfall

Will County Board Finance Committee Meeting | October 21, 2025 Article Summary: As Will County officials look for ways to close an $8.9 million budget gap, a debate has emerged over...
Peotone fire district graphic logo.1

Manhattan Fire District Earns Clean Audit, Hires Investment Manager

Manhattan Fire Protection District Meeting | September 15, 2025 Article Summary: The Manhattan Fire Protection District received a clean bill of financial health with an "unmodified opinion" on its latest audit....
Meeting Briefs

Meeting Summary and Briefs: Manhattan Village Board for October 21, 2025

Manhattan Village Board Meeting | October 21, 2025 The Manhattan Village Board on Tuesday, October 21, 2025, approved the annexation and preliminary plans for the 41-home Butternut Ridge South subdivision....