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

Govt shutdown predicted to drag on after funding bill fails for 8th time in Senate

Govt shutdown predicted to drag on after funding bill fails for 8th time in Senate

By Thérèse BoudreauxThe Center Square It’s been two weeks since the federal government shut down, and lawmakers are no closer to reaching a deal after U.S. Senate Democrats voted down...
Supreme Court rejects bid to overturn H-1B visa rule

Supreme Court rejects bid to overturn H-1B visa rule

By Andrew RiceThe Center Square The U.S. Supreme Court on Tuesday declined to hear a case challenging a rule that allows spouses of H-1B workers to work in the United...
Johnson tells Democrats to 'bring it' over pay for U.S. troops

Johnson tells Democrats to ‘bring it’ over pay for U.S. troops

By Brett RowlandThe Center Square President Donald Trump's weekend move to pay U.S. troops during a partial government shutdown raised legal questions, but it also relieved pressure on Republicans as...

WATCH: Pritzker vows to continue battling Trump over ‘abuses’ around public safety

By Greg Bishop | The Center SquareThe Center Square (The Center Square) – The war of words continues between President Donald Trump and Illinois Gov. J.B. Pritzker over public safety...
Lawmakers, advocates discuss battery storage, consumer costs in energy bill

Lawmakers, advocates discuss battery storage, consumer costs in energy bill

By Jim Talamonti | The Center SquareThe Center Square (The Center Square) – An Illinois state lawmaker is pushing battery storage legislation, but not all of her Democratic colleagues are...
Houston-based company makes LNG history in Alaska

Houston-based company makes LNG history in Alaska

By Bethany BlankleyThe Center Square Texas-based companies continue to lead the U.S. in oil and natural gas production – including in Alaska. A Houston-based company has helped make history by...
Massachusetts university visa program under threat of H-1B fee

Massachusetts university visa program under threat of H-1B fee

By Andrew RiceThe Center Square Certain H-1B visa programs across the country could be under threat as the Trump administration cracks down on the program with a new $100,000 fee....
Illinois quick hits: State Farm sued; ag education grants announced; 'Operation Summer Heat' results

Illinois quick hits: State Farm sued; ag education grants announced; ‘Operation Summer Heat’ results

By Jim Talamonti | The Center SquareThe Center Square State Farm sued The state of Illinois is suing Illinois-based State Farm insurance, alleging the company refused to comply with a...

U.S. military strikes another suspected drug boat near Venezuela

By Brett RowlandThe Center Square A U.S. military strike on a suspected drug boat off the coast of Venezuela on Tuesday killed six suspected traffickers, the latest in recent weeks...
WATCH: Frustration mounts with Dept. of Corrections 'unseriousness,' 'timeliness problem'

WATCH: Frustration mounts with Dept. of Corrections ‘unseriousness,’ ‘timeliness problem’

By Jim Talamonti | The Center SquareThe Center Square (The Center Square) – The Illinois Department of Corrections has begun scanning prison inmates’ mail, but lawmakers are not happy with...
Illinois audit commission members worried about ‘ghost’ health care networks

Illinois audit commission members worried about ‘ghost’ health care networks

By Greg Bishop | The Center SquareThe Center Square (The Center Square) – Concerns about ghost medical insurance networks and zombie state boards and commissions were raised during a review...
Exclusive: District to repay $3 million to property owners

Exclusive: District to repay $3 million to property owners

By Elyse ApelThe Center Square The National Taxpayers Union Foundation recently secured a major legal victory in Colorado that will result in $3 million in taxpayer reimbursements for certain property...
WATCH: CCTV footage captures attempted murder of Pennsylvania governor

WATCH: CCTV footage captures attempted murder of Pennsylvania governor

By Christen SmithThe Center Square The Dauphin County District Attorney's Office released more than five minutes of CCTV footage that captured Cody Balmer setting fire to Gov. Josh Shapiro's official...
Most Americans say U.S. heading in the wrong direction, poll finds

Most Americans say U.S. heading in the wrong direction, poll finds

By Brett RowlandThe Center Square A new poll shows about 55% of registered voters think the U.S. is headed in the wrong direction, including 74% of Latino voters, a key...
Balmer pleads guilty to attempted murder of Pennsylvania governor

Balmer pleads guilty to attempted murder of Pennsylvania governor

By Christen SmithThe Center Square The man accused of firebombing the Pennsylvania governor’s mansion in Harrisburg pleaded guilty to attempted murder, aggravated arson and terrorism on Tuesday. Cody Balmer also...