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

Manhattan Township

Manhattan Township Bridge Project Saved After County Commissioner Intervenes with Forest Preserve

A critical bridge replacement project in Manhattan Township, jeopardized by a stalemate with the Will County Forest Preserve District and the potential loss of $500,000 in funding, has been saved...
Manhattan Township

Soltage Solar Farm Clears Township Hurdle with Detailed Landscaping Plan

A proposed solar farm by Soltage Renewable Energy has cleared a key local hurdle after its representative presented a detailed landscaping and aesthetics plan that satisfied the Manhattan Township Board....
Manhattan Township

Solar Developer Commits Up to $800,000 for Smith Road Improvements

Summit Ridge Energy, a solar farm developer, has committed to providing up to $800,000 for the engineering and construction of improvements along Smith Road, Manhattan Township officials announced Tuesday. The...
Manhattan Township

Meeting Briefs: Manhattan Township for February 11, 2025

Baker Road Bridge Work Imminent: Highway Commissioner Jim Baltas reported that the Road District crew will soon begin trimming trees to prepare for the upcoming construction on the Baker Road Bridge....
Manhattan Township

Manhattan Township to Review Solar Farm Proposal at Special Meeting

Manhattan Township will host a special meeting Jan. 28 to review a proposed solar farm development at the corner of Cherry Hill and Manhattan roads. Soltage Renewable Energy Provider has...
Manhattan Township

Manhattan Township Briefs

Township Approves $81,000 Assessor Budget: Manhattan Township trustees unanimously approved the 2025-2026 assessor's office budget request of $81,000 during their Jan. 14 meeting. The budget includes increases for employee salaries...
Jackson Township

Jackson Township Property Values to Rise 13% in 2025 Assessment

Jackson Township property owners will see assessed values increase by 13.18% in the upcoming assessment cycle, Assessor LeGrett reported at the township's January 8 monthly meeting. The increase, which will...
Jackson Township

Jackson Township Advances Infrastructure Projects Despite Winter Conditions

Jackson Township continues progress on major infrastructure improvements while maintaining winter road operations, officials reported at the January 8 township meeting. Supervisor Matt Robbins updated the board on the ongoing...
Jackson Township

Jackson Township Meeting Briefs

Meeting Approvals: Jackson Township trustees unanimously approved December 2024 meeting minutes and the monthly financial statement during their January 8 meeting. The board also approved the assessor's 2025 budget as...
Police blue and red flashing light on the car in the street

Manhattan Police Reports

Disclaimer: Charges against each defendant are merely an accusation, with all defendants presumed innocent unless proven guilty in a court of law. On November 25, officers cited Parker, Kenneth R (53) of...
Blue flasher light of siren of police car

Manhattan Police Reports

Disclaimer: Charges against each defendant are merely an accusation, with all defendants presumed innocent unless proven guilty in a court of law. On November 17, officers cited Randle, Devante (24) of...