New Report: Billions of Dollars Wasted, Consumers Harmed Due to Health Care Fraud in Obamacare Plans

Washington, D.C.—U.S. Senator Mike Crapo (R-Idaho), Chairman of the Senate Finance Committee, issued the following statement on a new report from the Government Accountability Office (GAO) identifying several avenues of widespread fraud in Obamacare Marketplace plans, including large-scale failures that have allowed applicants using fake identities, stolen Social Security numbers and incorrect income estimates to receive Obamacare subsidies at taxpayers’ expense.

“The GAO’s findings further illustrate the brokenness of Obamacare,” said Crapo. “The temporary, enhanced COVID-era credits have exacerbated Obamacare’s structural failures, causing fraud to explode and leaving taxpayers to subsidize criminals and shady insurance brokers. Premiums and out-of-pocket costs are rising for all Americans, but as we look for ways to improve the health care system, this investigation serves as a stark reminder that we cannot simply throw good money after bad policy.”

As part of its investigation, GAO created fake identities and attempted to enroll them in Obamacare advance premium tax credits (PTCs), a taxpayer-funded subsidy for Obamacare recipients. All four of its fake applicants were approved in 2024 and 18 of 20 fake applicants in 2025 were receiving subsidies as of September.

The Obamacare Marketplace accepted some of these enrollees with falsified proof of income, Social Security numbers and citizenship status, and others were approved even when no documents were submitted.

In addition to successfully enrolling almost all its fake applicants in the subsidy program, the GAO found the program was at risk of the following forms of fraud:

• Identity theft: 66,000 Social Security numbers were enrolled in multiple plans in 2024.
• One Social Security number was enrolled in 125 different policies, totaling 71 years’ worth of credits, in 2023.
• $94 million in subsidies went to plans created with Social Security numbers belonging to a deceased individual.
• Unauthorized changes: In 2024, 160,000 applications for PTCs were likely changed by insurance brokers without the authorization of the enrollee.
• In just eight months, the Centers for Medicare and Medicaid Services received over 270,000 complaints from Americans who were enrolled or switched into plans they did not want.
• These changes allow brokers to charge fees they should not receive and can disrupt enrollees’ care.
• Credit overpayment: Nearly a third of PTCs paid in 2023 were not reconciled to enrollees’ income.
• Without this check, enrollees can receive larger subsidies by intentionally misrepresenting their income at the time of enrollment.

The investigation was requested by Congressmen Jason Smith (Missouri), Brett Guthrie (Kentucky) and Jim Jordan (Ohio).

Read the report HERE.

Related:

• U.S. House Committee on Ways and Means: Watchdog Finds Consumer Harm and Billions of Taxpayer Dollars Wasted in Health Care Fraud in Affordable Care Act Plans

• U.S. House Committee on Energy and Commerce: Non-Partisan Watchdog Finds Consumer Harm and Tens of Billions of Taxpayer Dollars Wasted Due to Health Care Fraud in Affordable Care Act Plans

###