House Judiciary panel probes insurance companies over Obamacare fraud

The House Judiciary Committee is probing insurance companies over Obamacare fraud, asking eight of them for information.The committee sent letters to Blue Shield of California, Centene Corporation, CVS Health, Elevance Health, GuideWell, Health Care Service Corporation, Kaiser Permanente, and Oscar Health, Inc., requesting documents as the panel examines Obamacare subsidies for fraud.
“Some of the fraud comes from brokers, who are paid by insurance companies for each enrollment and are, therefore, incentivized to enroll as many people as possible—whether eligible or not,” the committee wrote in its letters.
“Brokers have targeted individuals with deceptive advertisements and pressured enrollees to lie about their incomes to obtain Obamacare subsidies. Evidence suggests that many individuals do not even know they are signing up for health insurance or agreeing to switch plans.”
Earlier this month, the Government Accountability Office found fraud in Obamacare subsidies, including $94 million paid to insurers for deceased people. The committee cited the report in its letters.
The GAO found that 58,000 Social Security numbers received advanced premium tax credits that matched Social Security death data. At least 7,000 of those were dead before coverage started.
GAO investigators created fictitious identities with fake or never-issued SSNs, all of which submitted applications that were approved in late 2024, and 18 of 20 of those are still receiving subsidized Affordable Care Act coverage this year.
The committee also noted in its letters that the Trump administration issued a regulation that would have required federal agencies to “check for subsidy eligibility in certain instances before someone enrolls, verify income when an enrollees [sic] claimed income does not match IRS data, and allow for verification of income when tax data is unavailable.”
However, a federal judge blocked the regulation, claiming it violated the Administrative Procedure Act, which the Trump administration is appealing.
The committee asked the insurance companies in the letters for information regarding Obamacare subsidies dating back to 2020.

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