A recent article from Breitbart has drawn attention to a Government Accountability Office (GAO) report that highlights concerns about waste, fraud, and abuse in Affordable Care Act (ACA) marketplace plans. The report was requested by House Judiciary Committee Chairman Jim Jordan (R-OH), Ways and Means Chairman Jason Smith (R-MO), and Energy and Commerce Committee Chairman Brett Guthrie (R-KY).
According to the GAO report, there are significant issues with the Advance Premium Tax Credit (APTC), a subsidy designed to lower monthly health insurance premiums for consumers. The report found that covert operations using fictitious identities resulted in all fake applicants being approved by the Centers for Medicare & Medicaid Services (CMS) as recently as 2024, with 90 percent of these fraudulent applicants still receiving coverage in 2025.
Chairman Guthrie stated, "Republicans have consistently prioritized protecting patients and taxpayers by ridding our federal health programs of the waste, fraud, and abuse that ultimately drive up costs for patients." He continued, "Republicans have sounded the alarm on the flawed structural integrity of Obamacare and how Democrats’ failed policies to temporarily prop up the program have exacerbated fraud, hurt patients, increased the burden on American taxpayers, and artificially masked the true health care affordability crisis plaguing Americans today. The concerning findings from GAO’s report further confirm that Republican efforts to strengthen, secure, and sustain our federal health programs are critical and necessary to ensure access to quality health care at prices Americans can afford."
Chairman Jordan commented, "For years, we were told we could keep our plan, keep our doctor, and premiums would go down. None of it happened. This new report confirms what we already knew: under Obamacare, hardworking Americans saw their premiums skyrocket and their healthcare choices shrink, all while fraud benefitted insurance companies. Obamacare was built on lies and broken promises that hurt families and drove up costs."
Smith added his perspective: "While Democrats defend waste, fraud, and abuse, Republicans are taking action to lower health care costs and protect care for all real, living Americans. GAO’s troubling 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."
The GAO investigation revealed specific instances where subsidies were issued improperly. For example:
- 58,000 Social Security numbers used for APTC matched records indicating those individuals were deceased.
- 7,000 people had died before their coverage began.
- $94 million in subsidies went to insurers on behalf of deceased individuals.
The Congressional Budget Office (CBO) has previously estimated that millions may be enrolled in ACA plans improperly. Improper payments related to these enrollments could total as much as $27 billion.
GAO's findings align with previous warnings about risks associated with ACA subsidies. In response to these ongoing issues with fraud and improper payments in federal healthcare programs like those under Obamacare—also known as the ACA—House Republicans have advocated for reforms such as stricter income verification requirements before issuing subsidies.
Jodey Arrington (R-TX), House Budget Committee Chairman said: "It was Democrats who created this shoddy subsidy program with no financial controls, no income cap, and no guardrails against the most blatant fraud including approval of subsidies for thousands of dead people."
The president also weighed in: "I am recommending to Senate Republicans that the Hundreds of Billions of Dollars currently being sent to money sucking Insurance Companies in order to save the bad Healthcare provided by ObamaCare BE SENT DIRECTLY TO THE PEOPLE SO THAT THEY CAN PURCHASE THEIR OWN MUCH BETTER HEALTHCARE and have money left over." He added: "In other words take from the BIG BAD Insurance Companies give it to the people and terminate per Dollar spent the worst Healthcare anywhere in the World ObamaCare."
