Senators Call for DOJ Investigation into ACA Subsidy Legitimacy

Senators Urge DOJ Investigation into ACA Subsidy Claims

U.S. Senator Roger Marshall, along with other Republican senators, is calling for a Department of Justice (DOJ) probe into the legitimacy of subsidy payments under the Affordable Care Act (ACA). Initiated by Senator John Cornyn, this request suggests that these payments may arise from unauthorized or improper enrollments, potentially imposing a financial burden on taxpayers. The senators argue that flawed AI-driven processes within the ACA marketplaces contribute to these compliance issues.

Between January and August 2024, the Centers for Medicare & Medicaid Services (CMS) received approximately 275,000 consumer complaints, highlighting unauthorized enrollments or unwanted policy changes affecting federal subsidy disbursements. The senators underline that each improper enrollment in ACA plans harms taxpayers directly. Furthermore, they emphasize the urgent need for regulatory compliance checks, as more than $180 million have already been allocated due to incorrect processes.

The Government Accountability Office (GAO) supports this concern, noting persistent fraud risks and an alarming lack of evidence for reconciling over $21 billion in subsidies related to the 2023 tax year. Senators demand robust civil measures from the DOJ to recover misallocated funds, stressing the importance of proper underwriting and risk management in the ACA system. To understand the senators' complete perspective, stakeholders are encouraged to review the full letter, made available by Senator Roger Marshall's office.