A new Government Accountability Office (GAO) investigation has uncovered massive fraud and systemic weaknesses in the Affordable Care Act (ACA) marketplace, including fake identities receiving subsidies, misuse of Social Security numbers, billions in unreconciled payments, and insurers collecting tax credits for deceased individuals.
The report validates longstanding Republican concerns that the ACA subsidy system lacks basic safeguards, creating opportunities for criminals, identity thieves, and unscrupulous brokers to exploit taxpayers.
GAO Findings: A System Vulnerable to Fraud
GAO investigators conducted a test by creating fictitious applicants using fake or never-issued Social Security numbers. The Centers for Medicare & Medicaid Services (CMS) approved coverage for all of them in late 2024.
Key findings include:
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100% of fake applicants were approved.
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18 out of 20 fake applicants continued receiving subsidized coverage in 2025.
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CMS approved coverage with no documents or with fraudulent documents, including fake citizenship papers.
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Brokers bypassed verification by enrolling applicants via call centers without their presence.
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Monthly subsidies paid on behalf of GAO’s fake identities exceeded $12,300 per month.
Widespread Misuse of Social Security Numbers
The GAO also documented rampant abuse of Social Security numbers:
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One SSN was used on over 125 applications, equivalent to 71 years of subsidized coverage.
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In 2024, 66,000 SSNs were used for more than one year of subsidized coverage in a single year.
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CMS lacks mechanisms to prevent duplicate applications with the same SSN.
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$21 billion in subsidies were paid in 2023 without evidence of tax reconciliation, representing roughly 32% of all advanced premium tax credits.
Subsidies Paid to Deceased Individuals
GAO matched ACA enrollment data with Social Security death records and found 58,000 SSNs receiving subsidies belonged to deceased individuals, with at least 7,000 dying before coverage began. Insurers collected $94 million in taxpayer-funded subsidies for these deceased applicants.
“These findings show that criminals armed with nothing more than fabricated paperwork—or no paperwork at all—can easily extract taxpayer subsidies,” GAO investigators said. The report highlights the lack of verification, reconciliation, and accountability within the ACA marketplace.
Republicans have cited the findings as evidence that Obamacare’s subsidy system is fundamentally flawed and have pledged to restore guardrails, protect taxpayer dollars, and increase accountability in federal health care programs.