A new Government Accountability Office investigation has uncovered extensive fraud in the Affordable Care Act’s subsidy system, prompting top House Republicans to call for reforms and stronger verification measures.
By yourNEWS Media Newsroom
House Judiciary Chairman Jim Jordan (R-OH), Ways and Means Chairman Jason Smith (R-MO), and Energy and Commerce Chairman Brett Guthrie (R-KY) said Wednesday that a new report from the Government Accountability Office (GAO) exposes serious vulnerabilities in the Affordable Care Act’s Advance Premium Tax Credit (APTC) system. The program, a core part of the Obamacare framework, provides subsidies to insurers to lower monthly health insurance premiums.
The GAO’s report found that systemic flaws in verification and oversight have allowed large-scale fraud to persist. In covert testing, investigators submitted fictitious identities to the Centers for Medicare & Medicaid Services (CMS) and found that 100 percent of the fraudulent applications were approved as recently as 2024, with 90 percent still receiving subsidies in 2025.
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The agency also identified 58,000 Social Security numbers linked to APTC payments that matched Social Security death records, and $94 million in subsidies issued to insurers on behalf of deceased individuals.
Chairmen Guthrie, Jordan, and Smith—who jointly requested the investigation—said the findings confirm longstanding Republican warnings about waste and abuse in the Obamacare subsidy structure.
“Republicans have consistently prioritized protecting patients and taxpayers by ridding our federal health programs of waste, fraud, and abuse that ultimately drive up costs,” Guthrie said in a written statement. “The concerning findings from GAO’s report further confirm that efforts to strengthen and secure these programs are essential to ensuring affordable, quality health care for Americans.”
Jordan added that “this new report confirms what we already knew: under Obamacare, hardworking Americans saw premiums rise and choices shrink, while fraud benefitted insurance companies.”
Smith described the GAO’s findings as “the smoking gun” showing that “the federal government has sent tens of billions of tax dollars to insurers through identity fraud,” arguing that the program’s structure has contributed to higher healthcare costs for all Americans.
The GAO has repeatedly warned that the APTC system remains at high risk for improper payments and identity fraud. A 2024 Congressional Budget Office review estimated that millions may be improperly enrolled in ACA plans, accounting for as much as $27 billion in erroneous payments.
Republicans have proposed reforms through President Donald Trump’s Big Beautiful Bill, which would require full income and eligibility verification before subsidies are issued, end “anytime” enrollment practices that enable fraudulent sign-ups, and close loopholes allowing ineligible individuals to receive taxpayer-funded benefits.
Trump reiterated his position on healthcare funding in a Truth Social post, writing:
“I am recommending to Senate Republicans that the Hundreds of Billions of Dollars currently being sent to money sucking Insurance Companies in order to save the bad Healthcare provided by ObamaCare, BE SENT DIRECTLY TO THE PEOPLE SO THAT THEY CAN PURCHASE THEIR OWN, MUCH BETTER, HEALTHCARE, and have money left over.”
The GAO’s findings are expected to guide upcoming legislative hearings as congressional committees weigh additional oversight measures to prevent further subsidy abuse and protect federal healthcare funds.
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