GAO finds fraud in Obamacare subsidies, $94 million paid to insurers for deceased people

The Government Accountability Office found fraud in Obamacare subsidies, including $94 million paid to insurers for deceased people, according to the GOP-led House Ways and Means Committee.

The committee on Wednesday announced the GAO's findings, which included 58,000 Social Security Numbers receiving advanced premium tax credits that matched Social Security death data. At least 7,000 of those were dead before coverage started.

GAO investigators created fictitious identities with fake or never-issued SSNs, all of which submitted applications that were approved in late 2024, and 18 out of 20 of those that are still receiving subsidized Affordable Care Act coverage this year. Coverage was approved even when no documents were requested or fake documents were submitted, including fake citizenship eligibility documents.

Monthly subsidies paid to health insurers on behalf of these fake identities exceeded $12,300.

In 2023, a single SSN was used on applications for more than 125 insurance policies totaling over 26,000 days of coverage, which is the equivalent of 71 years. Last year, 66,000 SSNs had more than a year's worth of subsidized coverage.

GAO also found that there were $21 billion in subsidies paid out without evidence of tax reconciliation in 2023.

Centers for Medicare and Medicaid Services received 275,000 complaints from January to August 2024 from Americans who were enrolled in or switched into plans without their consent. GAO found that 160,000 likely unauthorized changes were made by three or more brokers in 2024.

According to the Congressional Budget Office and independent external research organizations, there are millions of people in the ACA marketplaces who may be enrolled improperly, costing taxpayers as much as $27 billion annually in improper payments.

House Ways and Means Committee Chairman Jason Smith said in a statement on Wednesday, “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.

“While Obamacare fraud is being confirmed by GAO, CMS, CBO and other outside reports, patients are suffering. They face higher health care costs and denied claims or delayed care when their providers struggle to verify which insurance is valid due to these fraud schemes. Rather than simply rubber stamp more bad spending and failed policies, we must take action to prevent further harm.”