ACA Enrollment Fraud Now Tops 6 Million — And Taxpayers Are Footing a $27 Billion Bill
The report says improper and phantom sign-ups could cost taxpayers $27 billion a year, as federal watchdogs and prosecutors uncover widespread fraud.
- On Wednesday, June 3, 2026, the Paragon Health Institute released a report estimating roughly 6.2 million people on Affordable Care Act exchanges are improperly enrolled in subsidized coverage, representing about 27 percent of all exchange sign-ups.
- Excessive subsidies, weak verification systems, and misaligned incentives for enrollment intermediaries created a 'perfect storm' for phantom enrollments, according to Brian Blase, president of Paragon Health Institute.
- Centers for Medicare and Medicaid Services data shows 35% of exchange enrollees filed zero medical claims in 2024, while nearly 60% of enrollees in HealthCare.gov states reported unknown race or ethnicity—patterns consistent with unauthorized activity.
- The Department of Justice pursued accountability, with a federal jury convicting Cory Lloyd and Steven Strong in a $233 million fraud scheme and ordering $180.6 million in restitution, while AssuredPartners agreed to a $135 million civil settlement.
- While the administration pursues program-integrity reforms, critics argue that tightening enrollment rules could disproportionately harm low-income Americans, creating tension in Washington's health policy debate; independent researchers have disputed Paragon's methodology, contending estimates may be overstated.
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11 Articles
The Daily Caller
Obamacare Enrollment Fraud May Cost Taxpayers Billions In 2026, New Study Shows
Widespread fraud across the Affordable Care Act is projected to cost American taxpayers billions in 2026, according to a new Paragon Health Institute report.
Medical Daily
Health Journal OnlineACA Enrollment Fraud Now Tops 6 Million — And Taxpayers Are Footing a $27 Billion Bill
A sweeping new report released today confirms what critics of the Affordable Care Act have warned for years: millions of ineligible individuals are receiving federally subsidized health coverage, draining tens of billions in public funds through a system riddled with structural loopholes and almost no accountability.
Watchdog Flags 6.2 Million Obamacare Enrollees for Fraud
A conservative health policy group is warning that millions of Americans may be improperly enrolled in Obamacare, with the Paragon Health Institute estimating that 6.2 million ACA exchange enrollees — about one-quarter of the total — may be ineligible for subsidized coverage, potentially costing taxpayers up to $25 billion this year.
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