Federal investigators identify weaknesses that allowed improper enrollments and payments to continue into 2025.
The House Ways and Means Committee responded to a preliminary report from the Government Accountability Office (GAO) that found systemic weaknesses in the Affordable Care Act (ACA) marketplace that allowed ineligible or fictitious applicants to receive federally subsidized health coverage. As part of its investigation, the GAO conducted undercover testing and found that all fake applicants were approved for coverage in late 2024, with most continuing to receive subsidies in 2025.
The report also documented widespread misuse of Social Security numbers, including repeated use of the same number across multiple policies, and payments issued on behalf of individuals listed as deceased. The GAO warned that these failures can lead to billions of dollars in improper payments and create disruptions for legitimate consumers, including unexpected costs or coverage confusion.
“Rather than simply rubber stamp more bad spending and failed policies, we must take action to prevent further harm,” said Ways and Means Committee Chairman Jason Smith of Missouri.
The report noted that federal agencies overseeing the marketplaces, including the Centers for Medicare and Medicaid Services (CMS), face ongoing challenges in preventing improper enrollments and ensuring subsidies are issued only to eligible individuals.
As the Lord Leads, Pray with Us…
- For Comptroller General Gene Dodaro, GAO investigators, and federal health officials as they work to strengthen oversight and safeguard public resources.
- For Administrator Oz, CMS officials, and marketplace administrators as they address verification gaps and protect consumers from unintended harm.
Sources: House Ways and Means Committee
