Episode 987: Obamacare Enrollment Fraud

Newt talks with Elle Minarik, from the Paragon Health Institute, about their new report, “The Persistent Obamacare Enrollment Fraud” which details the widespread fraud and improper enrollment in Affordable Care Act (ACA) exchange plans, driven by enhanced federal subsidies, weak verification systems, and misaligned incentives for insurers and intermediaries. Paragon Health Institute’s analysis compares Census data on people with incomes between 100–150% of the federal poverty level to the number of highly subsidized enrollees, estimating that 6.2 million people are enrolled in heavily subsidized plans despite not having incomes in that range. They project about $25 billion per year in improper Obamacare enrollment by 2026, with at least $75 billion over the last three years, and note that in one year alone $40 billion in federal payments went to insurers for “zero-claim” enrollees who never used their coverage. Improper enrollment is highly concentrated in non–Medicaid expansion states, especially Florida and Texas, which together account for 63% of projected improper enrollees in 2026; five states including Florida, Texas, Georgia, South Carolina, and North Carolina account for 78%.See omnystudio.com/listener for privacy information.