House Judiciary Committee Chairman Jim Jordan, along with Subcommittee on the Administrative State, Regulatory Reform, and Antitrust Chairman Scott Fitzgerald and Subcommittee on Oversight Chairman Jeff Van Drew, have sent requests for documents and information to several major health insurance companies. The companies contacted include Blue Shield of California, Centene Corporation, CVS Health, Elevance Health, GuideWell, Health Care Service Corporation, Kaiser Permanente, and Oscar Health.
The committee is conducting oversight into subsidies provided under the Affordable Care Act (Obamacare), citing concerns about waste, fraud, and abuse in the program. According to a recent report from the U.S. Government Accountability Office (GAO), tens of thousands of Social Security Numbers were used by fraudsters to obtain Obamacare subsidies improperly.
The committee notes that some brokers are paid by insurance companies for each enrollment they facilitate. This payment structure may incentivize brokers to enroll as many individuals as possible regardless of eligibility. There have been reports that brokers have targeted people with misleading advertisements and pressured them to misrepresent their incomes in order to qualify for subsidies. In some cases, individuals reportedly did not know they were enrolling in health insurance or changing plans.
Earlier this year, a federal judge blocked a Trump Administration regulation intended to address subsidy fraud under Obamacare after finding it violated the Administrative Procedure Act.
Letters requesting further information have been sent individually to each company involved as part of the ongoing investigation.
