Tag Archives: Obamacare fraud

ObamaCare Fraud

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On Saturday, PJ Media posted an article about fraud in ObamaCare.

The article reports:

Obamacare is expensive, unconstitutional, socialist, and bloated. It is also — surprise, surprise — riddled with fraud.

Health and Human Services Secretary Robert F. Kennedy Jr. and Centers for Medicare and Medicaid Services (CMS) Administrator Mehmet Oz revealed the stunning number of Obamacare users who never provided a Social Security number, raising serious questions about the scope of fraud in the government healthcare insurance program.

…In a Saturday video, Kennedy and Oz updated the American people on efforts to uncover and root out fraud. The HHS secretary began, “The Obamacare marketplace is plagued by fraud, in large part because the Biden administration dismantled basic program integrity guardrails. [And] partisan lawfare blocked common sense efforts to protect taxpayers. Today, Dr. Oz and I are exposing one of the latest examples of fraud that we’ve uncovered — more than a million people enrolled in Obamacare without Social Security numbers on file. That is a glaring warning side of fraud. If even a single person was on Obamacare with no Social Security number, we should have found out. Why are we paying people we don’t know if they actually exist?” Why indeed. Probably because Democrats love to redistribute money no matter how many criminals benefit.

The article notes:

But the current administration has a zero tolerance attitude toward fraud, Oz emphasized. “So here’s what we’re doing about it,” he said. “In May, we took swift action to block this fraudulent behavior directly on healthcare.gov and to our marketplace Call Center. If an agent wants to be paid, [he] must follow the rules. No ifs, ands or buts. They are gonna have to provide government-verified information for their clients to be enrolled.”

This effort is bearing fruit, Kennedy stated. “Thanks to this aggressive enforcement strategy, we’ve already eliminated thousands of fraudulent policies, and we’re just getting started. We’re also working with insurers to cancel every policy that should never have been issued and recover every taxpayer dollar that was fraudulently paid out,” he assured Americans.

Eliminating fraud may be one of the least painful way to cut government spending and get deficits under control.

Allowing Space For Fraud In Obamacare

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On Tuesday, The Federalist posted an article about one aspect of Obamacare that is often unused and provides a gateway for fraud.

The article reports:

Obamacare failed to make health care more affordable. Every day the government shutdown lumbers on, more Americans are looking more closely at health care costs and learning just how damaging the impact of Obamacare has been.

The latest evidence comes from the Obamacare exchanges which have seen a spike in “zero-claim enrollees.” Because of irresponsible Biden-era policies, federal subsidies were increased during Covid. Health insurers received payments on behalf of 35 percent of enrollees—and 40 percent of fully subsidized enrollees—who did not use a single service for the time period they were covered. Zero-claim enrollment, which is more than double the rate in a typical health insurance market, is consistent with evidence of widespread fraud.

So the insurance companies were receiving money from the government on behalf of people who did not use the insurance. It is very possible widespread fraud was involved.

The article notes:

The main explanation for the rise in zero-claim enrollees is the tremendous amount of fraud and abuse endemic to Obamacare. The data does not lie. In 2025, there are more than 6.4 million ineligible people enrolled in a fully subsidized Obamacare plan—and in 15 states there are more than twice as many people enrolled in fully subsidized plans than are eligible. And the examples of the fraud are overwhelming, as a huge money-making apparatus from lead generators to unscrupulous agents and brokers to insurers made massive profits from the fraud. Millions have been enrolled without their consent or knowledge, falling victim to fraud schemes. 

Obamacare supporters and the health insurance industry cannot have it both ways. Those who downplay the fraud simply show that Obamacare is broken in other ways as the coverage does not translate into any care—not a single visit to the doctor, prescription filled, or lab test ordered. The reality is that both explanations indict the law. If millions of enrollees are fraudulent, taxpayers are being robbed. If such a large number of enrollees are real but not using any care, Obamacare’s central theory collapses—that generous subsidies and “free” preventive services would drive better health and savings. Either way, the system is failing on its own terms.

Sunsetting Obamacare subsidies is a good idea. The Democrats previously agreed to do that. Now the Democrats are trying to undo that (along with a number of other spending boondoggles) by shutting down the government. I would rather see the government continue to be shutdown than to ask American taxpayers to fund the Democrats’ list of demands.