[Congressional Record Volume 171, Number 208 (Wednesday, December 10, 2025)]
[Senate]
[Pages S8583-S8584]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                          AFFORDABLE CARE ACT

  Mr. GRASSLEY. Mr. President, on Monday, the Wall Street Journal 
editorial board published an article titled ``ObamaCare is a Mecca For 
Fraud.''
  It articulates the waste, fraud, and abuse in the ObamaCare Program, 
so I am going to read this article on the floor today and do it for the 
benefit of my colleagues that maybe don't always read these editorials.
  So quoting, and I will try to leave out commentary comment. If I do 
that, I will identify it as such.

       The Minnesota Medicaid grift illustrates how open-ended 
     government welfare can easily become an inducement for fraud. 
     A new Government Accountability Office report finds the 
     pandemic-era sweetened ObamaCare subsidies are . . . ripe for 
     gaming.
       The GAO last fall began an undercover test in which it 
     submitted insurance applications for fictitious individuals 
     to the federal ObamaCare exchange and insurance brokers. 
     Nearly all of its invented people were able to enroll in 
     subsidized plans despite submitting false or no records to 
     verify their identities and incomes.
       Of GAO's 24 applications, 23 were approved. Eighteen 
     enrollees were still covered as of September, suggesting that 
     the exchange and insurers didn't verify information even 
     after enrollment. The subsidies paid to insurance companies 
     for those 18 applicants totalled more than $10,000 per month, 
     equivalent to a $6,700 annual subsidy for each enrollee.
       GAO says in some cases ``we were not prompted to provide 
     documentation'' to verify an applicant's identity. No Social 
     Security number? No problem. In another instance, the 
     ObamaCare exchange ``notified us that it had verified the 
     applicant's estimated income based on documentation we 
     submitted. However, we did not submit documentation.''
       In two cases, brokers called the ObamaCare help center 
     because applicants had submitted invalid Social Security 
     numbers. The center let brokers submit the

[[Page S8584]]

     fraudulent applications anyway. This suggests the Centers for 
     Medicare and Medicaid Services, which runs the federal 
     ObamaCare exchange, was ignoring fraud.
       GAO also analyzed enrollment data in 2023 and 2024 for data 
     anomalies. It found more than 29,000 Social Security numbers 
     in 2023 and nearly 68,000 in 2024 that were used to receive 
     more than one year's worth of insurance coverage with 
     subsidies in a single year--meaning the same Social Security 
     number was used by more than one person.
       In 2023 one Social Security number was used to apply for 
     more than 125 policies. Perhaps this was identity theft, but 
     it's also possible brokers submitted fake Social Security 
     numbers to enroll ineligible or phantom people in plans. 
     Brokers earn more in commissions from insurers if they enroll 
     more people in ObamaCare.
       The Justice Department has charged numerous brokers with 
     enrolling people in ObamaCare plans, or switching them to new 
     plans, without their consent. GAO identified at least 30,000 
     applications in 2023 and 160,000 in 2024 that had ``likely 
     unauthorized changes by agents or brokers.''
       GAO also found that incomes weren't later verified for 
     enrollees who received $21 billion in subsidies in 2023. That 
     means they might have received bigger subsidies than they 
     were eligible for. The Paragon Health Institute's Brian Blase 
     has warned that ObamaCare's lax verification controls 
     encourage people to understate income to get bigger 
     subsidies.
       Using Census Bureau data, Mr. Blase estimates that about 
     6.4 million people this year were improperly enrolled in 
     subsidized ObamaCare plans, costing taxpayers $27 billion. He 
     has also found that about 40 percent of enrollees in plans 
     fully subsidized by the government filed no medical claims. 
     GAO's report suggests many may not be real people. Others may 
     have employer coverage and been enrolled by brokers without 
     their knowledge.
       This year's GOP tax bill included modest reforms to prevent 
     ObamaCare fraud, such as requiring the exchange to verify 
     Social Security numbers and income data before enrolling 
     applicants in plans. It also requires people to repay the 
     government if their incomes turn out to be higher than 
     what they estimated on their applications. The 
     Congressional Budget Office projected that the tax bill's 
     ObamaCare fraud controls could result in about one million 
     more people going uninsured, but most aren't eligible for 
     subsidies--and some might not even exist.
       Democrats want to boost enrollment in ObamaCare no matter 
     the cost because they view the subsidized and regulated plans 
     as a way-station to a single-payer system. Senate Minority 
     Leader Chuck Schumer plans to tee up a vote this week to 
     extend the pandemic-era subsidies, which have been an 
     inducement for fraud.
       Republicans would be wise to remind voters that Democrats 
     sold ObamaCare on false pretenses--e.g., it would make 
     healthcare ``affordable.'' Extending the subsidies would 
     perpetuate that fraud.

  That is the end of my reading of the Wall Street Journal of Monday of 
this week.
  I yield the floor.
  I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The senior assistant legislative clerk proceeded to call the roll.
  Mr. THUNE. Mr. President, I ask unanimous consent that the order for 
the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.

                          ____________________