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New findings from a congressional watchdog claim that Obamacare’s COVID-19-era subsidies are riddled with errors and that its administrators struggle to shut out fake or incomplete applications.
Last week, the Government Accountability Office (GAO), a nonpartisan agency that examines congressional spending, found that Obamacare is picking up the tab for tens of thousands of accounts, using enhanced premium tax credits (APTCs) to pay for more than one coverage plan, deceased account holders and applicants lacking identifying information.
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A user views the federal enrollment website for Obamacare at an enrollment event in Milford, Delaware. (Andrew Harrer/Bloomberg via Getty Images)
“GAO’s preliminary analyses identified over 29,000 SSNs (Social Security numbers) in 2023 and nearly 68,000 SSNs in 2024 used to receive more than one year’s worth of insurance coverage with APTC in a single plan year,” the report read.
In addition to the evaluation of real-world fraud, the GAO also created several fake accounts to see if Obamacare would prevent them from receiving benefits.
“Of 20 fictitious applicants, 18 remain actively covered as of September 2025. APTC for these 18 enrollees totals over $10,000 per month. GAO continues to monitor the enrollments as part of its ongoing work,” the GAO said.
The GAO stressed that its findings “cannot be generalized to the enrollee population.” Notably, the fraud detected accounts for less than 1% of all of Obamacare’s users.
GAO’s findings come as lawmakers wrestle with whether to extend the enhanced premium subsidies for Obamacare set to expire at the end of the year that were first passed to help policyholders pay for health insurance during the COVID-19 pandemic. Without them, Democrats fear that the vast majority of Obamacare policyholders — over 90% of the program’s 24 million enrollees — could find themselves suddenly stuck with significantly higher premiums overnight.
Republicans remain split on whether lawmakers should extend the subsidies in some way. The fiscally conservative wing of the GOP believes letting them expire would mark a critical step towards bringing the country back towards pre-COVID spending levels.
The GAO’s findings play into a key Republican concern: that government health programs may carry unnecessary bloat, and that continuing them in their current state would simply extend those inefficiencies.
Continuing the subsidies would cost the country upwards of $30 billion a year, according to research from the Committee for a Responsible Federal Budget.
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Healthcare costs are set to rise for Americans across the U.S. starting next year, both Republicans and Democrats warn. (Wodicka/ullstein bild via Getty Images)
While the GAO’s evaluation found issue with a relatively small slice of Obamacare’s overall population, the watchdog also struggled to tie an significant amount of the APTC’s expenses to SSNs.
“GAO’s preliminary analysis of data from tax year 2023 could not identify evidence of reconciliation for over $21 billion in APTC for enrollees who provided SSNs to the federal Marketplace for plan year 2023,” the report said.
As a part of that picture, the GAO reported that in 2023, over $94 million in APTC funding had gone to SSN numbers associated with deceased recipients. But not all applicants who receive APTCs may have SSNs in the system to begin with.
According to GAO’s research, the federal marketplace requested applicants to use an SSN, proof of citizenship and reported income. The GAO found that it could get access to benefits without them.
“GAO did not provide documentation yet received coverage,” the report said of its research through fake accounts.
CONGRESS FACES HOLIDAY CRUNCH AS HEALTH CARE FIX COLLIDES WITH SHRINKING CALENDAR
Discussions about rising costs for healthcare, primarily surrounding Obamacare, have divided Republicans, and they contemplate whether to reform or replace the system. (By Lea Suzuki/The San Francisco Chronicle via Getty Images; Stefani Reynolds/Bloomberg via Getty Images)
Some of Obamacare’s struggle to maintain a clear picture of which SSNs are tied to which policies stem from built-in flexibility for when things go wrong.
Government officials explained that the federal marketplace does allow enrollees to use one SSN to obtain more than one policy. That allows applicants to secure access to health insurance in the event of identity fraud or data entry errors.
“Officials explained that the federal Marketplace does not prohibit multiple enrollments per SSN to help ensure that the actual SSN-holder can enroll in insurance coverage in cases of identity theft or data entry errors,” the report read.
The Department of Health and Human Services did not immediately respond to a request for comment.
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The Senate is set to vote on whether to extend the APTCs in their current form for three years by the end of this week. Amid fierce Republican opposition across both chambers of Congress, that vote is expected to fail.
