The US Government Accountability Office (GAO) released a report on December 3 revealing widespread healthcare fraud, resulting in losses potentially reaching billions of taxpayer dollars in funding under the Patient Protection and Affordable Care Act (PPACA), also known as “Obamacare.”
According to the legislation, the federal government provides advance premium tax credits (APTC) to eligible enrollees to lower their monthly premiums with health insurance companies. In the 2024 insurance year, it is estimated that the total amount of such credits paid to insurance companies will be close to $124 billion, involving about 19.5 million enrollees.
The GAO report exposed extensive misuse of Social Security Numbers (SSNs) due to identity theft and related fraudulent activities.
Furthermore, in the 2023 insurance year, over 29,000 SSN numbers obtained insurance coverage with APTC for 365 days or more, indicating multiple Obamacare enrollees using these SSNs.
The GAO found that the most frequently used SSN in 2023 was used to secure over 26,000 days (over 71 years) of subsidized insurance coverage across over 125 policies.
In the 2024 insurance year, the GAO discovered that nearly 66,000 SSNs had insurance coverage for more than 366 days.
The excessive use of SSNs was attributed to identity theft, synthetic identity fraud, and data input errors, according to the GAO.
Moreover, the report revealed instances of deceased individuals’ SSNs being used to fraudulently obtain benefits.
For the 2023 insurance year, the GAO identified over 58,000 instances where SSNs receiving APTC matched the death records of the Social Security Administration.
The GAO analyzed 26,000 of these SSNs associated with deceased individuals, estimating that federal health insurance and Medicaid programs paid over $94 million in APTC subsidies for them.
In a statement on December 3, the House Ways and Means Committee remarked that the GAO’s investigation uncovered “massive systemic failures,” allowing individuals to exploit Obamacare subsidies through false identities, SSNs, and identities of deceased persons.
The committee emphasized that not only did this result in unnecessary federal spending, but it also harmed those truly in need by potentially depriving them of essential medical services and increasing out-of-pocket costs.
Chairman of the committee, Republican Congressman Jason Smith from Missouri, emphasized the urgent need to address these issues to prevent further misuse of taxpayer dollars and the escalating healthcare costs for all Americans.
The GAO’s examination focused on the program’s ability to combat fraud risks. Investigators created 20 fictitious identities and submitted fraudulent individual healthcare insurance applications through the federal marketplace, which offers insurance purchasing plans under the PPACA.
In October 2024, the GAO submitted applications for four fictitious identities.
The report revealed that “the federal marketplace approved full-subsidy insurance from November to December 2024 for our four fictitious applicants. The total APTC amount paid to the insurers for the four fictitious enrollees was around $2,350 per month.”
The analysis identified vulnerabilities in the marketplace’s identity verification processes.
Out of the four applications, two were submitted through the HealthCare.gov website. Although initially unsuccessful in the online identity verification step, approval was granted after submitting fictitious identification documents.
The remaining two applications were submitted by brokers who collaborated with the federal marketplace call center and successfully submitted the applications despite the GAO providing invalid SSN numbers earlier.
For the 2025 insurance year, the GAO applied for health insurance for all 20 fictitious identities. Initially, the marketplace approved insurance for 19 identities, with 18 applications remaining valid as of September 2025.
These 18 fictitious enrollments had a total monthly APTC payment exceeding $10,000.
While these fictitious applications may not represent all cases, they underscore weaknesses in the risk management of the healthcare program.
As the GAO’s report surfaced, the Democratic Party was pushing to extend enhanced Obamacare tax credits beyond the end of December.
“If Congress fails to act, the healthcare costs of tens of millions of Americans will skyrocket,” said House Democratic Leader Hakeem Jeffries during a press conference on December 1, advocating for extending the subsidies for an additional three years.
In another letter to members of Congress on the same day, Jeffries blamed the upcoming healthcare crisis on the Republicans’ refusal to “extend tax credits under the Affordable Care Act.”
In a post on Truth Social on November 8, former President Donald Trump proposed direct payments of $2,000 to low and middle-income Americans instead of subsidizing insurance companies, allowing individuals to choose their insurance plans.
In addition, Trump mentioned on November 14 that the White House was in discussions with members of Congress regarding this proposal and had engaged in “personal talks” with some Democratic legislators.