Fake applicants granted Obamacare subsidies

Fake ID? Forget beer, buy health insurance as this undercover investigation highlights flaws in ACA enrollment process.

Insurance News


Undercover federal investigators, working on behalf of the Government Accountability Office, were able to obtain subsidized health insurance with fraudulent paperwork and fabricated identities.
Of 12 fictitious applicants who sought enrollment by phone or online, 11 were approved for ACA coverage.  Although six operatives were denied during the online process, they were subsequently approved when they tried to apply through a call center.  
“For one application, the marketplace denied coverage because GAO’s fictitious applicant did not provide a Social Security number as part of the test,” said Seto Bagdoyan, acting director of audit services for GAO's Forensic Audits and Investigative Service.
He notes that the combined credits for these applicants amount to $2,500 monthly or about $30,000 per year.  They remain covered to this day.

The GAO also tested in-person enrollment centers.  In five of six attempts, the undercover agents were refused help.  Only in one did an enrollment specialist recognize that the applicant’s stated income was too high to receive subsidized coverage.
While the GAO operation reveals weaknesses in the ACA application process, the agency reiterates that findings are preliminary and a full investigation will take months.
Still, Republicans are eager to use these discoveries to add to their case for dismantling Obamacare.
“We are seeing a trend with Obamacare information systems: under every rock, there is incompetence, waste, and the potential for fraud,” Ways and Means Committee Chairman Dave Camp told NBC News.
“Last month, we found that the administration was unable to verify income or eligibility for insurance subsidies.  Now, we learn that in many cases, the exchange is unable to screen out fake identities or documents.”


Keep up with the latest news and events

Join our mailing list, it’s free!