Health Care

GAO finds Obamacare fraud is easy

December 17, 2025

Ray Carter

A review by the federal Government Accountability Office (GAO) found it is relatively easy for individuals to fraudulently obtain taxpayer-subsidized insurance through Obamacare, and that millions of dollars may have been expended on fraudulent applications, according to testimony presented at a recent U.S. Senate hearing.

During the hearing, conducted by the U.S. Senate Homeland Security and Government Affairs Subcommittee on Border Management, Federal Workforce and Regulatory Affairs, U.S. Sen. James Lankford asked officials about GAO efforts to test whether fraudulent identification is accepted by officials running the Affordable Care Act (“Obamacare”) marketplace.

Lankford, R-Oklahoma City, noted that the report results “were pretty stark on this.”

Seto Bagdoyan, a director for audit services in the U.S. Government Accountability Office’s Forensic Audits & Investigative Service mission team, told Lankford his agency developed 20 scenarios to test fraud controls with 10 bogus applications run through HealthCare.gov and 10 others through brokers.

Bagdoyan said 19 of the 20 bogus applications were accepted, although one was later flagged by the federal Centers for Medicare and Medicaid Services (CMS).

“But we do have 18 of them that cost the government over $10,000 a month in premiums,” Bagdoyan said.

Lankford asked if any pattern existed among the fraudulent applications accepted.

“Is this false Social Security numbers, or is this multiple Social Security numbers?” Lankford asked. “Is this just entering Mickey Mouse and a fake address in Orlando?”

“Everything is fake, sir,” Bagdoyan responded. “All the information, driver’s license, the Social Security number, pay stubs, birth certificates, anything and everything that the marketplace has asked us to submit is fake.”

Lankford also questioned GAO officials about confirmed instances in which the same Social Security number has been used multiple times by those seeking taxpayer-subsidized insurance through an Obamacare exchange.

“What are you finding with the same Social Security number being used over and over and over again?” Lankford asked.

“I will highlight the most egregious one we have to date, which is 127 policies attached to a single number that’s costing the government about $600,000 a year in subsidies,” Bagdoyan said. “And it’s a mix of full-year and part-year policies. And the critical point is that the 33 full-year policies are spread across 13 different states, and they involve a mix of genders. So that is a red flag that something isn’t right here.”

However, he said officials at the federal Centers for Medicare and Medicaid Services have declined to address that fraud.

“When we pressed CMS on that, Mister Chairman, their response is, ‘We really are not going to do anything because we don’t want to kick off the wrong person,” Bagdoyan said.

Photo credit: Pete Souza, via Wikimedia Commons