GAO Report Uncovers Widespread Fraud in ACA Marketplace Subsidies

A Government Accountability Office (GAO) investigation has revealed significant fraud and abuse within the Affordable Care Act (ACA) marketplace, including the approval of fictitious identities using fake or invalid Social Security numbers (SSNs) to illegally obtain subsidies. The Centers for Medicare & Medicaid Services (CMS) failed to detect or prevent this misuse, resulting in billions of dollars in unreconciled and potentially improper payments. Additionally, insurers have collected $94 million in subsidies on behalf of deceased individuals due to failures in cross-referencing enrollment data with Social Security death records. These findings highlight substantial vulnerabilities in subsidy verification and accountability mechanisms, underscoring systemic weaknesses in the ACA marketplace's regulatory and compliance frameworks. The report raises concerns about taxpayer funds being exploited through identity fraud and the lack of reconciliation processes between CMS and insurers. This exposure is prompting calls for stricter oversight and reforms to restore fiscal controls over healthcare subsidies.