GAO Report Finds Significant Waste and Fraud in Expanded ACA Subsidies

A December 2025 Government Accountability Office (GAO) report highlights significant vulnerabilities in the Affordable Care Act's enhanced premium subsidies, which expanded eligibility up to $500,000 annual income. Testing revealed fraudulent claims were accepted with fictitious applicants receiving coverage and payments, indicating ongoing waste and fraud that increased insurance costs and government spending. The expanded subsidies, enacted under the American Rescue Plan Act during the COVID-19 pandemic, are projected to cost $450 billion over ten years, with GAO findings estimating CMS paid $94 million to households using deceased Social Security numbers. These findings influenced Congressional opposition to extending the subsidies, emphasizing regulatory and oversight challenges in ACA marketplace operations.