A new report from an institute whose president coordinated the development of health policies during President Donald Trump’s first term says millions of people are fraudulently obtaining health insurance subsidized by the federal government.
The Paragon Health Institute is a think-tank whose president, Brian Blase, is determined to root out corruption in the federal healthcare plan. “We don’t just write white papers,” he stated last December. “We focus on trying to make change.”
“The Biden administration’s attempts to make it easier for people to sign up for insurance through the federal marketplace website also allowed insurance brokers to commit fraud, experts across the political spectrum agree,” The Washington Post noted, adding, “The report estimates that the income of more than a quarter of the 24 million marketplace enrollees this year was misrepresented, often by brokers, so that the plan would be fully subsidized.”
“We have found that this improper enrollment and fraud surged over the past year—rising by more than one-quarter to now total nearly 6.4 million ineligible recipients,” the report, titled, “The Greater Obamacare Enrollment Fraud: The Fraud Got Much Worse in 2025,” states. “The Biden administration took a host of administrative actions that prioritized higher enrollment numbers over eligibility verification, allowing fraud to grow unchecked.”
The report explains:
Exchange enrollment fraud is driven by a combination of four factors: (1) the enhanced Obamacare subsidies, enacted as a temporary pandemic-era policy, which fully subsidize plans for people who report income between 100 and 150 percent of the FPL; (2) Biden administration policies that prioritized enrollment over eligibility verification and program integrity; (3) limits on how much the federal government can recover if insurers receive excess advance subsidies because of improper eligibility determinations; and (4) automatic re-enrollment, which perpetuates improper enrollments year after year.
… the perverse incentives of the system have attracted unscrupulous brokers. These brokers understand how to game Obamacare. They are driving fraudulent enrollments by exploiting the enhanced direct enrollment feature of HealthCare.gov, which allows third parties to enroll consumers without their direct interaction with the exchange.
In The Great Obamacare Enrollment Fraud, the precursor to the current report, the institute made six recommendations to deal with the fraud it found:
- Congress should permit the enhanced subsidies to expire after 2025.
- Congress should raise subsidy recapture limits to reduce incentives for people to misestimate their income.
- Congress or the next administration should limit automatic re-enrollment into exchange plans and end it for people moving from or into fully taxpayer-subsidized plans.
- Congress should appropriate cost-sharing reduction payments and prohibit silver-loading.
- Congress should conduct aggressive oversight of the Biden administration’s management of HealthCare.gov, enhanced direct enrollment, and insurer and broker actions to take advantage of misestimating income.
- Congress or the next administration should reverse policies of the Biden administration that enabled such widespread fraudulent enrollment, particularly the continuous open-enrollment period for people who report income below 150 percent of the Federal Poverty Level.
The current report staunchly supports President Trump’s budget bill, stating, “If the provisions of The One Big Beautiful Bill become law, five of Paragon’s six recommendations from The Great Obamacare Enrollment Fraud would be implemented. … The remaining reform, and the most important, is for Congress to permit the enhanced subsidies to expire after 2025.”
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[[{“value”:”
A new report from an institute whose president coordinated the development of health policies during President Donald Trump’s first term says millions of people are fraudulently obtaining health insurance subsidized by the federal government.
The Paragon Health Institute is a think-tank whose president, Brian Blase, is determined to root out corruption in the federal healthcare plan. “We don’t just write white papers,” he stated last December. “We focus on trying to make change.”
“The Biden administration’s attempts to make it easier for people to sign up for insurance through the federal marketplace website also allowed insurance brokers to commit fraud, experts across the political spectrum agree,” The Washington Post noted, adding, “The report estimates that the income of more than a quarter of the 24 million marketplace enrollees this year was misrepresented, often by brokers, so that the plan would be fully subsidized.”
“We have found that this improper enrollment and fraud surged over the past year—rising by more than one-quarter to now total nearly 6.4 million ineligible recipients,” the report, titled, “The Greater Obamacare Enrollment Fraud: The Fraud Got Much Worse in 2025,” states. “The Biden administration took a host of administrative actions that prioritized higher enrollment numbers over eligibility verification, allowing fraud to grow unchecked.”
The report explains:
Exchange enrollment fraud is driven by a combination of four factors: (1) the enhanced Obamacare subsidies, enacted as a temporary pandemic-era policy, which fully subsidize plans for people who report income between 100 and 150 percent of the FPL; (2) Biden administration policies that prioritized enrollment over eligibility verification and program integrity; (3) limits on how much the federal government can recover if insurers receive excess advance subsidies because of improper eligibility determinations; and (4) automatic re-enrollment, which perpetuates improper enrollments year after year.
… the perverse incentives of the system have attracted unscrupulous brokers. These brokers understand how to game Obamacare. They are driving fraudulent enrollments by exploiting the enhanced direct enrollment feature of HealthCare.gov, which allows third parties to enroll consumers without their direct interaction with the exchange.
In The Great Obamacare Enrollment Fraud, the precursor to the current report, the institute made six recommendations to deal with the fraud it found:
- Congress should permit the enhanced subsidies to expire after 2025.
- Congress should raise subsidy recapture limits to reduce incentives for people to misestimate their income.
- Congress or the next administration should limit automatic re-enrollment into exchange plans and end it for people moving from or into fully taxpayer-subsidized plans.
- Congress should appropriate cost-sharing reduction payments and prohibit silver-loading.
- Congress should conduct aggressive oversight of the Biden administration’s management of HealthCare.gov, enhanced direct enrollment, and insurer and broker actions to take advantage of misestimating income.
- Congress or the next administration should reverse policies of the Biden administration that enabled such widespread fraudulent enrollment, particularly the continuous open-enrollment period for people who report income below 150 percent of the Federal Poverty Level.
The current report staunchly supports President Trump’s budget bill, stating, “If the provisions of The One Big Beautiful Bill become law, five of Paragon’s six recommendations from The Great Obamacare Enrollment Fraud would be implemented. … The remaining reform, and the most important, is for Congress to permit the enhanced subsidies to expire after 2025.”
“}]]
