U.S. officials identify widespread fraud in Obamacare enrollments

U.S. health officials have identified widespread improper enrollments in the Affordable Care Act (Obamacare) marketplace, involving both double-enrollments and deceased individuals. The Centers for Medicare and Medicaid Services (CMS) and the Department of Health and Human Services (HHS) reported that approximately 189,000 people were improperly receiving subsidized coverage despite being deceased or already enrolled in other government programs like Medicare.

Officials have already removed 58,000 Medicare beneficiaries and 11,000 deceased individuals from the marketplace this year. These actions are expected to prevent roughly $738 million in improper subsidy payments this year and an estimated $1.5 billion annually in the future. Health Secretary Robert F. Kennedy Jr. stated that officials intend to pursue fraud and correct mistakes as evidence is identified.

Investigations suggest the issue may be systemic. A Government Accountability Office (GAO) undercover test found that fictitious identities were able to obtain subsidies. Additionally, research from the Paragon Health Institute noted that the number of exchange enrollees with no medical claims tripled between 2021 and 2024, reaching nearly 12 million, which may indicate widespread “phantom” enrollment where individuals are unaware they have coverage.