One of my fundamental investment theories over the past 40 years has been, “American Business thrives on skim, scam, and fraud.” You need look no further than the senior US Senator from Florida who ran a company responsible for the then world record Medicare fraud as example of this
Many conservatives believe that “single mothers on food stamps” are responsible for most of the fraud. But as the right wing think tank Paragon Health Institute explains…
{{ In nine states (Alabama, Florida, Georgia, Mississippi, North Carolina, South Carolina, Tennessee, Texas, and Utah), the number of sign-ups reporting income between 100 percent and 150 percent FPL exceed the number of potential enrollees. The problem is particularly acute in Florida, where we estimate there are four times as many enrollees reporting income in that range as meet legal requirements.
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Unscrupulous brokers are certainly contributing to fraudulent enrollment and the enhanced direct enrollment feature of HealthCare.gov appears to be a problem. Brokers just need a person’s name, date of birth, and address to enroll them in coverage, and reports indicate that many people have been recently removed from their plan and enrolled in another plan by brokers who earn commissions by doing so.
Health insurers are a primary beneficiary of the surge in improper enrollment from people misestimating income. The larger subsidies mean that consumers are less sensitive to prices of plans and are more likely to enroll, and it’s much easier for insurers to collect subsidies from the U.S. Treasury than customers. }}
Last week the Washington Post had an editorial that the expanded Obamacare subsidies should not be extended because of rampant fraud.
Obamacare subsidies make it too easy to scam the system https://www.washingtonpost.com/opinions/2025/12/08/aca-subsidies-gao-insurance-broker/ Preserving these credits, which are due to expire at the end of the year, would cost $350 billion over the next decade. Democratic leaders are trying to keep the subsidies intact without reforms to address abuse that has grown rampant in the system.
A report issued last week by the nonpartisan Government Accountability Office underscores why that should be a nonstarter. Investigators submitted 24 phony applications for Obamacare subsidies in the past two years, and all but one were approved. This was true of applications submitted via HealthCare.gov, which accepted fake identification documentation, and insurance brokers, some of which never even asked the auditors to verify their identity…
The GAO estimates that $21 billion was paid out, in 2023 alone, for enrollees who never confirmed that their subsidy matched their income…
Many honest people will feel the squeeze next year, but any serious effort to extend Obamacare subsidies would need to include lower income caps, require some out-of-pocket premiums and impose additional anti-fraud protections.
Why not prosecute the criminal millionaire health insurance brokers that perpetrated the fraud, rather than cutting benefits to “single mothers on food stamps”?
And also, keep them in jail, rather than pardon them.