WASHINGTON, D.C. - Ongoing investigative work conducted by the Government Accountability Office (GAO), in tandem with recent sentencings in federal cases targeting fraudulent enrollment, have uncovered concerning practices where fraudster agents and brokers enrolled patients in, or secretly switched patients' health plans through, the Affordable Care Act marketplace.
In a new report from GAO-that builds on a preliminary report released in December 2025-at least 160,000 federal marketplace applications in plan year 2024 were found to have likely unauthorized changes, ultimately resulting in unexpected costs for patients, higher copayments and deductibles, and loss of access to treatment and medications.
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:
"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," said Chairman Guthrie. "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."
Congressman Jason Smith (MO-08), Chairman of the House Committee on Ways and Means:
"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. Today, GAO released a more detailed report confirming that this failed system has hugely inadequate structural safeguards, enabling widespread unauthorized enrollments and plan changes," said Chairman Smith. "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."
Congressman Jim Jordan (OH-04), Chairman of the House Committee on the Judiciary:
"Obamacare is rife with fraud, improper enrollments, and theft of taxpayer dollars. Today's GAO report validates all of our concerns with the program," said Chairman Jordan.
BACKGROUND:
- In June 2024, House GOP leaders wrote to GAO, asking for further information on the growing fraud in the Obamacare marketplace.
- In November 2025, Committee leaders followed up with GAO, inquiring about millions of enrollees in the ACA marketplaces that may be enrolled improperly, 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 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.
- Today, GAO released an additional report highlighting issues related to program integrity and oversight of agents and brokers in health insurance marketplaces.
- In 2018, CMS's own fraud risk assessment identified agent and broker theft of consumer information as the single greatest fraud risk facing the federal Marketplace.
- 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.
