New Watchdog Report Confirms Significant Structural Failures Enabling Widespread Obamacare Fraud

WASHINGTON, D.C. - A new Government Accountability Office (GAO) report confirms significant structural weaknesses in the Obamacare Marketplace that have enabled widespread fraud by allowing bad actors to enroll Americans in - or secretly switch - their health plans without authorization.

Building on GAO's preliminary findings released in December 2025, the report identified at least 160,000 federal Marketplace applications in plan year 2024 with likely unauthorized changes, ultimately resulting in unexpected costs for Americans, higher copayments and deductibles, and loss of access to treatment and medications.

The GAO investigation was requested by Ways and Means Committee Chairman Jason Smith (MO-08), Energy and Commerce Committee Chairman Brett Guthrie (KY-02), and Judiciary Committee Chairman Jim Jordan (OH-04).

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

"Democrats created a broken health care system that has become a feeding frenzy for fraudsters while forcing hardworking Americans to accept higher prices and fewer choices for their care. Last December, at our committees' request, GAO issued a report exposing how fake identities, deceased individuals, and improper use of Social Security numbers were used to exploit Obamacare subsidies. GAO released a more detailed report confirming that this failed system has hugely inadequate structural safeguards, enabling widespread unauthorized enrollments and plan changes.

"Specifically, GAO found that enrollment essentially operates on an honor system, where no one at CMS is verifying that consumers are requesting health care and consumers are never notified when they are enrolled. This hurts working families, many of whom did not want and did not request the coverage they were enrolled in. GAO found at least 160,000 Marketplace applications in 2024 with likely unauthorized changes, exposing families to higher costs and disrupted coverage. Taken together with the committee's investigation to expose fraud in other areas, such as hospice, home health and durable medical equipment, this report helps underscore how much needs to be done to fight fraud, as the Trump administration is taking steps to do. Republicans are continuing to fight to close loopholes, expand access to quality health care, lower costs for working families, and protect taxpayer dollars."

House Energy and Commerce Committee Chairman Brett Guthrie (KY-02) said:

"Since June 2024, the Committees have been scrutinizing large-scale ACA enrollment fraud and the lack of program integrity within the ACA marketplace. Now, two years later, GAO has released even more findings, outlining how bad actors continue to exploit critical government health programs-without beneficiaries even knowing.

"The Biden-Harris Administration actively removed safeguards protecting Americans from unscrupulous actors taking advantage of them, including unauthorized enrollments and switching Obamacare plans. Democrats were happy to brag about the fraudulently inflated enrollment numbers, regardless of the costs to the American people. As we celebrate the one-year anniversary of the Working Families Tax Cuts, Republicans remain steadfastly committed to restoring program integrity within the ACA and finding solutions to benefit patients instead of unscrupulous brokers and agents."

House Judiciary Committee Chairman Jim Jordan (OH-04) said:

"Obamacare is rife with fraud, improper enrollments, and theft of taxpayer dollars. Today's GAO report validates all of our concerns with the program."

BACKGROUND:

• In June 2024, House GOP leaders wrote to GAO, requesting additional information on the growing fraud in the Obamacare Marketplace.
• In November 2025, Committee leaders followed up with GAO, asking whether millions of enrollees in the Marketplace may have been improperly enrolled, costing taxpayers as much as $27 billion a year in improper payments.
  • GAO's reporting found large-scale systemic failures that allow fake identities, dead people, and massive improper use of Social Security numbers to receive Obamacare subsidies.
  • As part of the analysis, GAO conducted covert operations that included creating fictitious identities with fake or never issued SSNs and still got subsidized Obamacare coverage, meaning criminals and fraudsters can too.
    • In fact, 100 percent of fake applicants were approved by the Marketplace as recently as late 2024, and 90 percent of fake applicants continued to receive coverage in 2025.
• In July 2026, GAO released an additional report highlighting issues related to program integrity and oversight of agents and brokers in health insurance marketplaces.
• Confirmed consumer complaints of unauthorized enrollments and plan switches increased over 450 percent in just two years, from 66,548 in 2023 to more than 300,000 in 2025.
• CMS's 2024 three-way verification call fix does not cover all transactions and relies on identity checks that are often public-still leaving the system vulnerable to bad actors.

READ: Watchdog Finds Consumer Harm and Billions of Taxpayer Dollars Wasted in Health Care Fraud in Affordable Care Act Plans

READ: House Republicans Vote to Lower Health Care Costs for All Americans

READ: Democrats' Failed Health Care Policies: Obamacare Fraud Results in Billions for Insurance Companies, Denied Claims for Patients

READ: Republicans Deliver Lower Health Costs, More Choice, and Greater Control for Working Families