ACA Enrollment Fraud Now Tops 6 Million — And Taxpayers Are Footing a $27 Billion Bill
The think tank said improper sign-ups account for about 27% of ACA exchange enrollments and may cost taxpayers up to $25 billion in subsidies.
- Released yesterday, the Paragon Health Institute report estimates 6.2 million people are improperly enrolled in Affordable Care Act exchanges, costing taxpayers up to $25 billion annually.
- Loosened income verification and COVID-era subsidy boosts, combined with misaligned broker incentives, created a system vulnerable to manipulation, fostering widespread 'phantom enrollment' where individuals are signed up without their knowledge.
- Investigations reveal a 96% failure rate for basic fraud detection, with Florida emerging as a significant hotspot; 35% of exchange enrollees generated zero medical claims in 2024, signaling unauthorized activity.
- Administrator Dr. Mehmet Oz stated the agency is "restoring integrity to ACA exchanges by cracking down on fraud," though critics contend the fraud figures are overstated.
- Projected enrollment declines over the next two years likely reflect removal of duplicate coverage as verification efforts tighten, with Paragon president Brian Blase noting these steps address the 'perfect storm for improper and phantom enrollments' undermining program integrity.
12 Articles
12 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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