News

WASHINGTON, D.C. – Today, Congressman Brett Guthrie (KY-02), Chairman of the House Committee on Energy and Commerce, delivered remarks on the House floor regarding H.R. 498, the Do No Harm in Medicaid Act, legislation that prohibits federal Medicaid funds from being used toward gender transition procedures for individuals under the age of 18.

Chairman Guthrie’s remarks on H.R. 498, the Do No Harm in Medicaid Act:

“I rise today in strong support of H.R. 498, the Do No Harm in Medicaid Act.

“This bill helps support our fellow hard-working Americans, whose valuable—and finite—taxpayer dollars should not continue to fund medically unnecessary care under the Medicaid Program.

“It is our duty as members of Congress to focus hard-earned taxpayer dollars on care that is medically necessary to improve the health of Americans.

“H.R. 498, the Do No Harm in Medicaid Act, does just that—prohibiting federal Medicaid dollars from going toward specified gender transition procedures for individuals under the age of 18.

“My fellow House Republicans, and particularly my colleagues on the Energy and Commerce Committee, have worked diligently this Congress to eliminate waste, fraud, and abuse in the Medicaid program through the Working Families Tax Cuts Act.

“Our goal is to eliminate unnecessary and improper spending to strengthen, secure, and sustain the Medicaid program for those who are truly among the most vulnerable populations: expectant mothers, their children, low-income seniors, and individuals with disabilities.

“CBO estimates that this bill would save taxpayers $445 million over a decade.

“I want to make it abundantly clear that this legislation, in no way, prevents minors from accessing medical care that they truly need.

“It simply prohibits the use of federal Medicaid funding on specified gender transition procedures that are medically unnecessary.

“This critical legislation builds upon our work in the Working Families Tax Cuts Act to create a more sustainable financial future for Medicaid and preserve the program for the times when people truly need to lean on it.”

WASHINGTON, D.C. – Today, Congressman Brett Guthrie (KY-02), Chairman of the House Committee on Energy and Commerce, and Congressman Dan Crenshaw (TX-02), issued a statement following House passage of H.R. 498, the Do No Harm in Medicaid Act—legislation that prohibits federal Medicaid dollars from going toward specified gender transition procedures for individuals under the age of 18.

“The Do No Harm in Medicaid Act helps strengthen, sustain, and secure our Medicaid program by ensuring federal Medicaid funding is not used for medically unnecessary care for minors,” said Chairman Guthrie. “I’m thankful to my colleague, Representative Dan Crenshaw, for his diligent work in protecting our nation’s children. It’s our duty as members of Congress to support our fellow Americans—especially our most vulnerable—by prohibiting valuable and finite taxpayer dollars from continuing to fund controversial, life-altering gender transition procedures for individuals under the age of 18.”

“Using Medicaid for unscientific, irreversible procedures on minors is an abominable betrayal of our most vulnerable,” said Rep. Crenshaw. “This is a crucial step in protecting our children from the depraved actors that would do them harm.”

Background on H.R. 498:

• H.R. 498, the Do No Harm in Medicaid Act, prohibits federal Medicaid funding for specified gender transition procedures for individuals under the age of 18.
• The House also passed this bill as a provision within H.R. 1, the budget reconciliation bill, on May 22, 2025.
• The Congressional Budget Office estimates that H.R. 498 would reduce direct spending for Medicaid and CHIP by $445 million over the 2026-2035 period.
• Publicly available polling has consistently indicated that Americans oppose providing children with puberty blockers and irreversible surgeries.
• The U.S. Department of Health and Human Services (HHS) announced today a series of proposed regulatory actions to carry out President Trump’s Executive Order directing HHS to end the practice of sex-rejecting procedures on children that expose young people to irreversible harm, including pharmaceutical or surgical interventions that attempt to align a child’s physical appearance or body with an asserted identity different from their sex.

WASHINGTON, D.C. – Marking a milestone in delivering affordable coverage to the American people, Members of House Republican Leadership, Committee Chairmen Brett Guthrie (KY-02), Jason Smith (MO-08), and Tim Walberg (MI-05), join Congresswoman Mariannette Miller-Meeks (IA-01) in applauding the passage of her bill, H.R. 6703, the Lower Health Care Premiums for All Americans Act.

Quote Attributable to Speaker Johnson, Majority Leader Scalise, Majority Whip Emmer, Conference Chairwoman McClain, and Congresswoman Miller-Meeks:

“Today, every House Republican voted to lower health care costs for all Americans. Every House Democrat voted against it. After months of empty ‘affordability’ rhetoric and forcing the longest government shutdown in American history, Democrats once again rejected a valuable, common-sense solution to address the unaffordability they created with their own health insurance law – the Unaffordable Care Act.

“House Republicans are taking meaningful action to fix what Democrats broke. For too long, Democrats have forced hardworking American taxpayers to bail out big health insurance companies for hundreds of billions of dollars. Meanwhile, Americans are left paying for increasingly expensive care with fewer choices, lower quality, and worse health outcomes. They broke America’s health care system and with today’s vote, Democrats have abandoned a critical opportunity to fix their own failed law.

“The Lower Health Care Premiums for All Americans Act puts patients first. It does exactly what its title promises and more: lowers premium costs, expands access to affordable, quality care, gives every American more options and flexibility to choose coverage that is best for their needs, and brings greater transparency to the health care system. It delivers twice the cost reduction of the Democrats’ temporary, COVID-era enhanced subsidies and brings those costs down for ALL Americans – not just some. House Republicans are working to fix what is broken, restore integrity in our nation’s health care system, and lower the cost of health care for every citizen.”

Quote Attributable to Energy and Commerce Committee Chairman Guthrie, Ways and Means Committee Chairman Smith, and Education and Workforce Committee Chairman Walberg:

“By passing the Lower Health Care Premiums for All Americans Act, the House is putting the wellbeing of all American patients at the forefront of our health care system. This is the product of our longstanding effort to make health insurance affordable for the American people. Families and small businesses benefit from commonsense measures like funding cost sharing reductions, which would lower health care premiums by 11 percent, while expanding choices for American patients, and bringing transparency to how pharmacy benefit managers (PBMs) operate.

“Republicans reject the waste, fraud, and abuse in Obamacare and know that Democrats’ temporary COVID-era subsidies aren’t a long-term answer. Americans would be worse off with Democrats’ plot to subsidize very high-income earners and to stuff big health insurance companies’ pockets with an additional $400 billion.

“Republicans are empowering patients while Democrats seek simply to write larger and larger checks to big insurance companies. Providing access to quality care at affordable prices begins with the Lower Health Care Premiums for All Americans Act. Democrats must stop rejecting solutions merely because they are Republican ones and should work with us to lower the cost of care for all Americans.”

Background on the Lower Health Care Premiums for All Americans Act:

• H.R. 6703, the Lower Health Care Premiums for All Americans Act, sponsored by Rep. Miller-Meeks (IA-01), would establish new rules for association health plans, modify requirements for individual and group health coverage, require contracts between plan sponsors and PBMs to meet certain standards, and appropriate funding for reductions in cost sharing.
• The Congressional Budget office (CBO) and the Joint Committee on Taxation estimate that enacting the bill would reduce the deficit by $35.6 billion over the 2026-2035 period.
• CBO also estimates that enacting the bill would reduce gross benchmark premiums by 11 percent, on average, through 2035.

WASHINGTON, D.C. – Today, Congressman Brett Guthrie (KY-02), Chairman of the House Committee on Energy and Commerce, delivered remarks on the House floor regarding H.R. 6703, the Lower Health Care Premiums for All Americans Act, legislation that establishes new rules for association health plans, modifies requirements for individual and group health coverage, requires contracts between plan sponsors and PBMs to meet certain standards, and appropriates funding for reductions in cost sharing.

Chairman Guthrie’s remarks on H.R. 6703, the Lower Health Care Premiums for All Americans Act, as prepared for delivery:

“I rise today in strong support of H.R. 6703, the Lower Health Care Premiums for All Americans Act.

“When the Democrats passed Obamacare over a decade ago, they sold the bill on the promise that it would lower health care costs and preserve plan options.

“‘If you like your plan, you can keep it. If you like your doctor, you can keep them.’

“These famous last words still haunt us.

“Today, we know that Obamacare has not lived up to Democrats’ lofty promises; instead, the consequences of that bill continue to burden American patients as they have since its enactment.

“Health care spending has nearly doubled since Obamacare passed. Health plan options have been decimated by Democratic overreach, and millions of Americans are saddled with medical debt across the country.

“Obamacare premiums are up 80 percent since the program’s inception, with patients paying on average $5,000 out of their own pocket to hit their deductible, and the average out of pocket spending maximum for one year is over $20,000!

“Without a doubt, Obamacare has proven to be unaffordable and unsustainable.

“In an attempt to respond to the affordability crisis created by Obamacare, Democrats leveraged a public health emergency to shovel hundreds of billions of dollars to big health insurance plans to mask the rising unaffordability of coverage.

“First in the American Rescue plan of 2021, and then again in the Inflation Reduction Act of 2023, Democrats sent temporary taxpayer funded ‘enhanced’ premium tax credits directly to the coffers of big health insurance plans.

“They did this without a single Republican vote of support.

“On both occasions, Democrats chose to make these COVID Credits temporary. They could have made them permanent, but they chose instead to focus on advancing priorities for wealthy Americans to buy subsidized EVs and for politically connected cronies to siphon federal dollars out of the Greenhouse Gas Reduction slush Fund.

“Now, Democrats are uniting behind a policy to send billions more taxpayer dollars to big health insurance plans.

“With the Democrats’ temporary COVID Credits set to expire at the end of the year, they are attempting to turn their policy failures into political gains—using the American people as collateral.

“It is worth reiterating – Democrats funded temporary band aids to cover up unaffordable care, they set the expiration dates, and they chose to fund liberal priorities instead of making them permanent.

“While Democrats continue to fearmonger, I wanted to shed light on what Republicans are doing to fix the Democrats’ affordability crisis, with policies that deliver real, lasting relief to the American people.

“This includes:

• Eliminating health plan gimmicks like silver loading, which will lower ACA premiums by 11 percent;
• Increasing transparency for pharmacy benefit manager middlemen and lowering drug costs for all Americans; and
• Increasing affordable plan choices and putting patients back in the driver’s seat for their own health care choices by instituting Association Health Plans, CHOICE Arrangements, and stop-loss insurance.

“This proposal results in more than double the premium reduction than the Democrats’ extension of the enhanced COVID subsidies. The Congressional Budget Office estimates the Republican plan before us will lower premiums by 11 percent, compared to just 5 percent from continuing the Democrats’ subsidies.

“These policies will also lower health care costs for all Americans, not just the roughly-seven percent of Americans enrolled in Obamacare.

“And many of these policies are bipartisan! Ending silver loading, addressing nefarious PBM practices, and strengthening the employer insurance marketplace have all garnered broad bipartisan support.

“I hope we can overlook the politics that are clouding the issue, come together to pass this bill, and continue work together into 2026 to deliver more affordable health care to all Americans.”

WASHINGTON, D.C. – Congressman Brett Guthrie (KY-02), Chairman of the House Committee on Energy and Commerce, delivered the following opening statement at today’s Committee on Rules hearing on H.R. 498, the Do No Harm in Medicaid Act.

Chairman Guthrie’s opening statement as prepared for delivery:

“Thank you, Chairwoman Foxx and Ranking Member McGovern for inviting me to testify today.

“House Republicans, and especially my colleagues on the Energy and Commerce Committee, have been focused on rooting out waste, fraud, and abuse in the Medicaid program this year already through the Working Families Tax Cuts Act.

“Our work to this point has been driven by the desire to create a sustainable financial future for the Medicaid program and to strengthen, secure, and sustain it for those who are truly among the most vulnerable populations: expectant mothers, their children, low-income seniors, and individuals with disabilities.

“Even with all of the important work we have accomplished this Congress, there is still more to be done.

“Americans work hard to make a living, and it’s our obligation as members of Congress to ensure taxpayer dollars are used to support care that is truly necessary in improving the health of Americans.

“H.R. 498, the Do No Harm in Medicaid Act, prohibits federal Medicaid dollars from going toward specified gender transition procedures for individuals under the age of 18.

“While CBO estimates that this bill would save taxpayers $445 million over a decade, I want to make it abundantly clear that this legislation does not prevent minors from accessing medical care that they truly need.

“It simply prohibits the use of federal Medicaid funding on specified gender transition procedures that are medically unnecessary.

“This legislation builds upon our work done in the Working Families Tax Cuts Act to create a more sustainable financial future for Medicaid and preserve the program for those who truly need it.”

WASHINGTON, D.C. – Congressman Brett Guthrie (KY-02), Chairman of the House Committee on Energy and Commerce, delivered the following opening statement at today’s Committee on Rules hearing on H.R. 6703, the Lower Health Care Premiums for All Americans Act.

Chairman Guthrie’s opening statement as prepared for delivery:

“Thank you, Chairwoman Foxx and Ranking Member McGovern for inviting me to testify today.

“Sixteen years ago, Democrats passed Obamacare and fundamentally changed how health care is offered in the United States. Democrats sold the bill by promising the American people that Obamacare would reduce health care costs, preserve plan choice, and lower premiums for the American people.

“However, here we are, a decade and a half later and it is obvious that the Democrats’ promises have not proven true. Health care spending has only increased, plan options have been depleted, and the American people are being crushed by the unaffordability of the one-size-fits-all, government-first approach Obamacare codified.

“Since its passage, health care premiums in the Obamacare marketplace have increased by 80 percent, deductibles are now on average $5,000, and the average out of pocket maximum sits at over $20,000. All the while, Obamacare policies redirected trillions in taxpayer dollars to big health insurance plans.

“Without a doubt, Obamacare has proven to be unaffordable.

“Seizing the opportunity of COVID-19, Democrats passed temporary ‘enhanced’ taxpayer-funded subsidies that go to big health insurance plans. These temporary COVID Credits were designed to mask the unaffordability of Obamacare, and they were passed not once, but twice, without a single Republican vote of support.

“Democrats have now argued that these additional subsidies should be permanent, but let’s not forget how we got here. It was Democrats that set up these credits to expire at the end of this year.

“When they were in charge, they chose not to make them permanent. If these subsidies are as essential as the rhetoric today would suggest, why would they choose to allow them to expire?

“In that same legislation, again passed with only Democrat votes, they chose to prioritize tax credits for the wealthy to buy electric vehicles and sent $27 billion dollars to Democrats’ politically connected friends through the Greenhouse Gas Reduction slush Fund (including $2 billion to a group that only had $100 in previous revenue), instead of making these enhanced tax credits permanent.

“Since the Democrats created these temporary COVID Credits we’ve seen an explosion of waste, fraud, and abuse that has exacerbated a major affordability crisis and hurt millions of Americans across the country.

“How have Democrats responded to this? By shifting the blame of their own failed policies onto Republicans, attempting to force legislation that would continue to send hundreds of billions straight to the coffers of big health insurance plans, and turning a blind eye to the growing evidence of widespread Obamacare fraud.

“They would rather put a Band-Aid on rising health care costs, masking their true impact on American families, rather than focus on policies to actually address the issue.

“The most frustrating part about this is that health care affordability is a real issue impacting all Americans, and in the past, Republicans and Democrats have worked together to pass policies that would have a real impact on lowering costs for everyone.

“Instead of working to pass policies that would implement real, lasting solutions to lower health care costs for all Americans, Democrats have chosen the partisan path in an attempt to turn their own Obamacare policy failures into political points.

“I am proud of the policies that Republicans have worked on as a part of the Lowering Health Care Costs for All Americans Act because they do exactly what the title of the bill says: advance real policies that lower costs for all Americans.

“The bill includes bipartisan policies that would finally take the first steps to hold drug industry middlemen, pharmacy benefit managers, accountable to their own customers: the American people. Policies in the Lowering Health Care Costs for All Americans Act would shine a light on nefarious practices perpetrated by these middlemen and lower drug costs for all Americans.

“The Lower Health Care Costs for All Americans Act would also finally appropriate funds for Cost Sharing Reductions. This policy would reduce ACA premiums by 11 percent – an even greater savings than extending the Democrats’ temporary COVID Credits. Funding CSRs has also enjoyed broad bipartisan support in the past, and it is a policy that was previously endorsed by my friends Ranking Member Pallone, Ranking Member Neal, and Ranking Member McGovern.

“I hope that we can work across the aisle to support this commonsense bill that would—without a doubt—increase health care affordability for all Americans.

“I also hope that, in 2026, Democrats will choose to rise above the politics and work with Republicans to advance real policy solutions that build on provisions included in the Lower Health Care Costs for All Americans Act to make health care even more affordable for the American people.”

WASHINGTON, D.C.  – In case you missed it, Breitbart recently published an article highlighting a GAO report requested by Chairman Brett Guthrie and other House Republican leaders, which exposed significant waste, fraud, and abuse in Affordable Care Act (ACA) marketplace plans. In Case You Missed It: “House Judiciary Committee Chairman Jim Jordan (R-OH), Ways and Means Chairman Jason Smith (R-MO), and Energy and Commerce Committee Chairman Brett Guthrie (R-KY) said a GAO report has revealed the staggering level of fraud that occurs thanks to Obamacare subsidies. “The Government Accountability Office (GAO) released a report on the massive levels of fraud that comes with the Advance Premium Tax Credit (APTC), an Affordable Care Act (ACA), or Obamacare, subsidy to health insurers to lower the monthly health insurance premiums. “Democrats shut down the government for weeks over the looming end-of-year expiration of the Enhanced Premium Tax Credit (EPTC), a more generous version of the APTC that the left-leaning party boosted through the Biden-era, coronavirus stimulus plan, the American Rescue Plan. Democrats continued the subsidies through the so-called Inflation Reduction Act, which will expire at the end of 2025. “The GAO, as part of its analysis, conducted covert operations, which included fictitious identities that flood insurers with unjustified subsides. It found that 100 percent of the fake applicants were approved by the Centers for Medicare & Medicaid Services (CMS) as recently as 2024, with 90 percent of the fraudulent applicants continuing to receive coverage in 2025. “Chairman Guthrie, Jordan, and Smith requested the GAO investigation; they said the GAO study reifies Republicans’ concerns about these Obamacare subsidies. “‘Republicans have consistently prioritized protecting patients and taxpayers by ridding our federal health programs of the waste, fraud, and abuse that ultimately drive up costs for patients,’ Chairman Guthrie in written statement. “He continued, ‘Republicans have sounded the alarm on the flawed structural integrity of Obamacare and how Democrats’ failed policies to temporarily prop up the program have exacerbated fraud, hurt patients, increased the burden on American taxpayers, and artificially masked the true health care affordability crisis plaguing Americans today. The concerning findings from GAO’s report further confirm that Republican efforts to strengthen, secure, and sustain our federal health programs are critical and necessary to ensure access to quality health care at prices Americans can afford.’ “‘For years, we were told we could keep our plan, keep our doctor, and premiums would go down. None of it happened. This new report confirms what we already knew: under Obamacare, hardworking Americans saw their premiums skyrocket and their healthcare choices shrink, all while fraud benefitted insurance companies. Obamacare was built on lies and broken promises that hurt families and drove up costs,’ Jordan said in a statement to Breitbart News. “‘While Democrats defend waste, fraud, and abuse, Republicans are taking action to lower health care costs and protect care for all real, living Americans. GAO’s troubling report is the smoking gun that shows how this broken system, shielded by Democrat policies, has led to the federal government shoveling tens of billions of tax dollars to insurance companies through identity fraud and caused health care costs to skyrocket for all Americans,’ Smith explained. “Prior research from the Congressional Budget Office (CBO) and other outside organizations have found that millions may be enrolled in Obamacare improperly, resulting in as much as $27 billion in improper payments. “The GAO report found :   58,000 Social Security numbers that received the APTC matched Social Security Administration death data 7,000 people who had Social Security were dead before coverage began, meaning the applications used Social Security numbers of dead people $94 million in APTC was sent to health insurers on behalf of deceased people “GAO noted in its report its had frequently warned that Obamacare subsidies are and have been at risk of fraud. Republicans have been sounding the alarm about Obamacare subsidy fraud. “‘While Obamacare fraud is being confirmed by GAO, CMS, CBO and other outside reports, patients are suffering. They face higher health care costs and denied claims or delayed care when their providers struggle to verify which insurance is valid due to these fraud schemes. Rather than simply rubber stamp more bad spending and failed policies, we must take action to prevent further harm.’ “Meanwhile, Republicans have worked to restore integrity in the American healthcare system. The Big Beautiful Bill stipulates full income and eligibility verification before subsidies are issued, ends ‘anytime’ enrollment abuse that would fuel fraudulent enrollment, and closing loopholes that would allow illegal aliens and other ineligible groups of people to access taxpayer-funded healthcare benefits. “Instead of using Obamacare subsidies that fuel health insurers’ profits, President Donald Trump has called to send federal healthcare dollars straight to the American people so they can use their money according to their healthcare needs. “House Budget Committee Chairman Jodey Arrington (R-TX) said in a statement: “‘It was Democrats who created this shoddy subsidy program with no financial controls, no income cap, and no guardrails against the most blatant fraud, including the approval of subsidies for thousands of dead people. ... “‘There is absolutely no justification for perpetuating these subsidies or the failed government-controlled Obamacare system Democrats are artificially propping up. Instead, Republicans should continue to implement reforms that lower costs, expand affordable options, and protect American taxpayers.’ “The president wrote : “‘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.’ “‘In other words, take from the BIG, BAD Insurance Companies, give it to the people, and terminate, per Dollar spent, the worst Healthcare anywhere in the World, ObamaCare,’ the president added.” ###

WASHINGTON, D.C.  – In a new preliminary  report  published by the Government Accountability Office (GAO), waste, fraud, and abuse have run rampant through Affordable Care Act marketplace plans, worsening health care plans for Americans, all while enriching big insurance companies. The new watchdog investigation finds 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 even conducted covert operations which even included creating fictitious identities that flooded health insurers with unjustified subsidies. In fact, 100 percent of fake applicants were approved by the ACA Marketplace as recently as late 2024, and 90 percent of fake applicants continue to receive coverage in 2025.  As the report notes, such practices can result in wasteful federal spending on subsidies for enrollees who are not eligible. Further, such practices can result in harm and unexpected costs for consumers. These can include loss of access to medical providers and medications, higher copayments and deductibles, or repayment of subsidies if income or other eligibility was misrepresented. The GAO investigation was  requested  by Committee on Energy and Commerce Chairman Brett Guthrie (KY-02), Committee on Ways and Means Chairman Jason Smith (MO-08), and Judiciary Committee Chairman Jim Jordan (OH-04).  Congressman Brett Guthrie (KY-02), Chairman of the House Committee on Energy and Commerce:  “Republicans have consistently prioritized protecting patients and taxpayers by ridding our federal health programs of the waste, fraud, and abuse that ultimately drive up costs for patients,”  said Chairman Guthrie.  “Republicans have sounded the alarm on the flawed structural integrity of Obamacare and how Democrats’ failed policies to temporarily prop up the program have exacerbated fraud, hurt patients, increased the burden on American taxpayers, and artificially masked the true health care affordability crisis plaguing Americans today. The concerning findings from GAO’s report further confirm that Republican efforts to strengthen, secure, and sustain our federal health programs are critical and necessary to ensure access to quality health care at prices Americans can afford.” Congressman Jason Smith (MO-08), Chairman of the House Committee on Ways and Means: “While Democrats defend waste, fraud, and abuse, Republicans are taking action to lower health care costs and protect care for all real, living Americans. GAO’s troubling report is the smoking gun that shows how this broken system, shielded by Democrat policies, has led to the federal government shoveling tens of billions of tax dollars to insurance companies through identity fraud and caused health care costs to skyrocket for all Americans,”  said Chairman Smith . “While Obamacare fraud is being confirmed by GAO, CMS, CBO and other outside reports, patients are suffering. They face higher health care costs and denied claims or delayed care when their providers struggle to verify which insurance is valid due to these fraud schemes. Rather than simply rubber stamp more bad spending and failed policies, we must take action to prevent further harm.”  Congressman Jim Jordan (OH-04), Chairman of the House Committee on the Judiciary: “For years, we were told we could keep our plan, keep our doctor, and premiums would go down. None of it happened. This new report confirms what we already knew: under Obamacare, hardworking Americans saw their premiums skyrocket and their healthcare choices shrink, all while fraud benefitted insurance companies. Obamacare was built on lies and broken promises that hurt families and drove up costs,”  said Chairman Jordan. GAO investigated the scope of improper payments and weakened program integrity within the ACA marketplace. Estimates based on analysis by both the Congressional Budget Office (CBO) and independent external research organizations indicate millions of enrollees in the ACA marketplaces may be enrolled improperly, costing taxpayers as much as $27 billion a year in improper payments and imposing a great deal of harm and distress on families and victims of alleged fraud. BACKGROUND: Investigators Created Fake Identities – and CMS Provided Taxpayer Subsidies GAO created fictitious identities with fake or never issued SSNs and still got subsidized ACA coverage, meaning criminals and fraudsters can too.  100 percent of fake applicants were approved in late 2024. 18 out of 20 fake applicants are still receiving subsidized coverage for 2025. CMS approved coverage even when no documents were requested or fake documents were submitted. This includes fake citizenship eligibility documents  confirming fraud concerns for illegal immigrants . Brokers were able to bypass verification by calling the call center and submitting applications without the applicant present. Monthly subsidies paid to health insurers on behalf of GAO’s fake identities exceeded  $12,300 per month . Shocking Misuse of Social Security Numbers Including a Single Social Security Number Used for Over 125 Policies for the Equivalent of 71 Years One Social Security Number (SSN) was used for “71 years” of subsidized coverage.  In 2023, one single SSN was used on applications for over  125 insurance policies  totaling over 26,000 days of coverage, the equivalent of 71 years. 66,000 SSNs in 2024 had more than a years’ worth of subsidized coverage. CMS does not block new applications using the same SSN and relies on a broken document-request process that often never works.  $21 billion in subsidies paid out with no evidence of tax reconciliation in 2023. That is 32 percent of all advanced premium tax credits (APTC) paid to identifiable SSN holders .  No reconciliation means no accountability, no verification, and likely billions in improper payments. Big Insurers Still Collecting Subsidies for Deceased Individuals 58,000 SSNs receiving APTC matched Social Security death data.  At least 7,000 were dead before coverage even began, meaning the applications used SSNs of deceased individuals.  $94 million in taxpayer-funded subsidies were sent to health insurers on behalf of deceased individuals. Explosive Growth in Unauthorized Plan Switches that Harm Consumers Bad actors engaged in mass unauthorized enrollment activity to chase commissions, resulting in: 160,000 likely unauthorized changes by three or more brokers in 2024. CMS itself received 275,000 complaints in just eight months (Jan–Aug 2024) from Americans who were enrolled in or switched into plans without their consent. Repeated Warnings Have Gone Unheeded by Democrats GAO has repeatedly warned that Obamacare subsidies are and have been at risk of fraud structurally.  For 2015 enrollment, GAO found that federal and state marketplaces approved coverage for fictitious applicants, and nearly all of those fake identities stayed enrolled—even after submitting fictitious documents or no documents at all. For 2016 enrollment, GAO again reported that CMS had failed to design basic eligibility safeguards, including controls to stop duplicate or overlapping subsidized coverage. These weaknesses were supercharged after Democrats enacted and repeatedly extended Biden’s COVID-era subsidy expansions, which facilitated millions of fully subsidized fraudulent enrollments, and without corresponding fraud controls, created the perfect environment for criminals, identity thieves, and unscrupulous brokers. With Stronger Integrity for Taxpayers, Republicans Have Taken Steps to Lower Premiums Republicans are focused on restoring accountability and fairness to the health care marketplace through program integrity reforms that save taxpayers billions of dollars and drive down costs for everyone: Full income and eligibility verification before subsidies are issued, ensuring assistance goes only to those who qualify. Ending “anytime” enrollment abuse that fueled fraudulent sign-ups and drove premiums higher for everyone. Closing loopholes that allowed illegal immigrants and other ineligible groups to access taxpayer-funded health benefits. Even the Congressional Budget Office has found that these measures have already produced $185 billion in savings for taxpayers and  reduced premiums by 0.6 percent . That’s real savings for working families. ###

WASHINGTON, D.C.  – Today, Congressman Brett Guthrie (KY-02), Chairman of the House Committee on Energy and Commerce, issued a statement following the House passage of H.R. 1262, the Mikaela Naylon Give Kids a Chance Act— a bipartisan piece of legislation which reauthorizes the FDA’s Rare Pediatric Disease (RPD) Priority Review Voucher (PRV) Program to incentivize the development of treatments for rare pediatric diseases, and authorizes the FDA to direct companies to study a combination of cancer drugs and therapies in pediatric trials. “H.R. 1262, the Mikaela Naylon Give Kids a Chance Act, builds on current programs to accelerate research and drug development for rare pediatric diseases, including cancer,” said Chairman Guthrie. “The reauthorization of the Rare Pediatric Disease Priority Review Voucher Program has led to over 50 new treatment approvals for nearly 40 different rare pediatric diseases, many of which had no options prior. The impact of this program is profound for patients, and I am grateful to the sponsors of this legislation and their commitment to promoting research and addressing gaps in pediatric therapeutics.” Background on H.R. 1262:   H.R. 1262 , the Mikaela Naylon Give Kids a Chance Act , is a comprehensive piece of legislation that increases access to innovative treatments for children by:  Reauthorizing the FDA Rare Pediatric Disease (RPD) Priority Review Voucher (PRV) Program through Fiscal Year 2029 and clarifies that orphan drug exclusivity applies to the approved indication, rather than the potentially broader designation;  Providing the Food and Drug Administration (FDA) with additional authority to require pediatric cancer trials for new combinations of drug therapies;  Authorizing the FDA to take enforcement action against companies that fail to meet pediatric study requirements under the Pediatric Research Equity Act (PREA);  Directing the FDA to establish an office in an Abraham Accord country to enhance facilitation with the agency; and   Requiring FDA to disclose to certain generic drug applicants if any ingredients cause a drug to be quantitatively or qualitatively different from the listed drug, speeding up patients access to more affordable medications.  ###