Washington, D.C. – President Biden’s temporary COVID-era “enhanced” Affordable Care Act (ACA) tax credits have resulted in unprecedented fraud, with wealthy insurance companies reaping the benefits at the expense of unaware or ineligible enrollees who cannot get the health care coverage they need. Yet to keep inflated subsidies flowing directly to health insurers including on behalf of illegal immigrants, Democrats kept the government shut down, forcing hardship on American families from missed paychecks to canceled flights.

Ways and Means Committee Chairman Jason Smith (MO-08) said:

“Obamacare fraud is a cash cow for insurance companies that is driving up health care costs for Americans, and Democrats have thus far refused to do anything about it. It’s estimated that improper payments in the Affordable Care Act’s marketplaces, including fraud, waste, and abuse, total billions of dollars annually, with some reports citing estimates of up to $27 billion a year. This fraud can directly impact the legitimate needs of patients, who may face denied claims or delayed care when their providers struggle to verify which insurance is valid due to the chaos created by schemes like people using stolen identities to sign up for multiple plans. Such confusion then leads to financial burdens and significant stress for individuals who are wrongly denied coverage for essential medical services because they are unaware of the fraudulent policies associated with their information.”

The surge in fraud traces back to the establishment of the Biden-era “COVID credits” that made taxpayers 100 percent fully subsidize millions of ACA plans, while loosening verification rules and allowing year-round sign-ups. These policies created irresistible incentives:

• Brokers could sign anyone up, or switch existing customers, for a $0 premium plan and get paid themselves.
• Insurers profited from a flood of new “members” who never filed a claim but generated monthly premium payments funded completely by American taxpayers.
• Consumers, unaware they’d been enrolled, only discovered the fraud when their tax refunds disappeared.

Republicans are working to restore integrity and affordability to America’s health care system, while Democrats prolonged a shutdown to try and keep billions in taxpayer dollars flowing to the insurers and brokers who benefit from this corruption.

The Cruel Reality of Obamacare Fraud

Across the country, innocent Americans are paying the price:

• A woman living in a homeless shelter was lured into signing false paperwork and lost her HIV treatment coverage as a result. Another said she had been paid to sign up “probably five times.”
• In Miami-Dade County, more supposedly low-income residents are now enrolled in free Obamacare plans than actually live there—despite most already having other health insurance or being ineligible due to their immigration status. 
• Ashley Zukoski (NC) lost a $4,100 tax refund after being unknowingly enrolled in a fully subsidized plan.
• Michael Debriae (NC) was enrolled in a plan without his consent and was on the hook for $2,445 in owed taxes.
• Amy Shepherd (GA) saw her plan switched three times without her consent, causing stress and consternation. 
• Conswallo Turner (TX) responded to a Facebook ad that promised “cash cards” resulting in multiple changes to her plan and dropping of coverage for her son, without her consent.
• Angela Wells (TX) saw her insulin copay jump from $2 to $50 after a broker switched her plan without consent.
• Evelyn Teah (IA) told regulators, “Oscar Insurance used me for a whole year. I never got a card, I never went to the doctor, but they collected every month.”
• Dafud Iza (FL) pleaded guilty in a $133 million fraud scheme enrolling homeless individuals using stolen data.
• Tiesha Foreman (GA) found out she owed the IRS $1,700 for a plan she never knew existed. Her family’s legitimate coverage was canceled after a rogue broker switched their policy without consent. 
• Randy Delaney (OH) discovered his family had a problem with their plan being switched without their consent when they went to the pharmacy to pick up insulin. “You can imagine my shock when they told us it was $1,096…” Lorie Delaney, his wife, said: “It’s just like somebody is in there just messing with your life every day.”
• “I believe this is the largest health insurance fraud case ever,” said Atlanta Attorney Jason Doss, who filed a lawsuit on behalf of families across the country.

Watchdogs Have Reported on This Fraud, but Democrats Have Done Nothing

The above examples are not isolated incidents. They are symptoms of a broken system that Democrats shut down the government to protect.

• 6.4 million individuals are estimated to be improperly enrolled in Obamacare plans, costing taxpayers $27 billion each year.
• The Congressional Budget Office (CBO) recently confirmed Republicans’ warnings that at least 2.3 million fraudulent enrollees are misreporting income in Obamacare, validating evidence from the Centers for Medicare & Medicaid Services (CMS), Government Accountability Office, and Department of Justice (DOJ) that fraud is widespread and growing.
• 12 million Obamacare enrollees in 2024 filed zero medical claims, meaning many never knew they were even covered. 
• $14 billion per year is wasted on people double enrolled in Medicaid and Obamacare. 
• The DOJ has charged brokers in Florida and Texas with orchestrating fraud rings totaling more than $294 million, targeting the homeless, mentally ill, and recovering addicts.
• CMS said it receivedapproximately 40,000 complaints of unauthorized plan switches and 50,000 complaints of unauthorized enrollments in the ACA marketplace in the first three months of 2024, alone.
• In April, victims and whistleblowers filed a national class action lawsuit against TrueCoverage, Enhance Health, and other marketing firms and brokers accused of luring consumers with false promises of cash cards and “stimulus benefits.” Internal emails revealed a culture of deception:
  • Agents were told to lie, avoid government inquiries, and “be vague” about nonexistent cash cards.
  • A whistleblower testified that “top performers were people lying bluntly,” enrolling families to hit sales targets.
  • Companies used personal data harvested from online ads offering “$6,400 grocery subsidies” to auto-enroll consumers into ACA plans — without consent — and capture their federal subsidy payments.