Study: Over 6 Million Obamacare Recipients Fraudulently Enrolled

A stunning new study has revealed that over six million individuals who are currently enrolled in the government’s Affordable Care Act health care insurance subsidy program (known as Obamacare) were signed up fraudulently, amounting to over a quarter of all Obamacare enrollees.

According to the new report conducted by the Paragon Health Institute, 6.2 million people are illegitimately enrolled in Obamacare, which means that taxpayer dollars will likely fund up to $25 billion in improper payments in 2026. The fraudulent enrollments are largely due to individuals or insurance agents falsifying income to qualify for larger subsidies.

As noted by The Wall Street Journal Editorial Board, enrollment in Obamacare plans has doubled in recent years due to COVID pandemic subsidies. After the subsidies expired, “The consensus in the healthcare establishment was that people would drop coverage.” But instead, 23.1 million people signed up for ACA coverage this year, just 1.2 million fewer than last year. “One reason is that subsidies for most enrollees remain very generous,” the board observed. “The government this year will pay 94% of the premium for the median enrollee — about $699 of a $741 monthly premium. … Nearly 30% of enrollees won’t have to pay premiums thanks to subsidies.”

In addition, Paragon found that “[m]any improper enrollees are likely phantom enrollees — people who are unaware of their enrollment, covered elsewhere, or entirely fictional. In 2024, 35 percent of exchange enrollees and 40 percent of fully-subsidized low-income enrollees generated no medical claims — double the percentage expected in a normal health insurance market.” The report further noted that “The Centers for Medicare & Medicaid Services (CMS) found that an average of 1.6 million people per month were simultaneously enrolled in Medicaid and subsidized exchange coverage.”

The Trump administration has taken a series of steps to address the fraud crisis. The Paragon report pointed out that almost two million improper enrollees have been removed “through actions targeting duplicate Medicaid-exchange enrollment and individuals who failed to comply with tax-filing requirements.” In addition, additional eligibility verification rules enacted by last year’s One Big Beautiful Bill and by the administration are set to take effect over the next two years.

During a White House press briefing on Tuesday, CMS Administrator Dr. Mehmet Oz detailed what occurred during the Biden administration that enabled widespread Obamacare fraud and what the Trump administration is doing to address it.

“[In] 2020, there were nine million people on Obamacare. … Today it’s more than 20 million,” he explained. “What happened? What happened was we completely took the guardrails off. And I know this because I’m working in the agency that actually was told to take the guardrails off, and because there wasn’t an earnest desire to keep track of whether you were appropriately on it or not. … We believe that 35%, roughly, of the people [who] are using the Affordable Care Act … exchanges [have] never used the program once. They’ve never filed a claim, may not be legit. And that actual number may translate to five [to] six million people we could be paying premiums for because they don’t have to contribute anything. … These are people who have Medicaid and someone, often a broker, dishonestly enrolling them in [the ACA], or they’re … getting full insurance paid for by us in multiple states at once. So we have evaluated these numbers. They are extremely concerning.”

After highlighting that a new process for rooting out Obamacare fraud was started by the administration two weeks ago after their initial rule was enjoined by a federal court, Oz went on to illustrate what will occur when fraud is rooted out and eligibility rules are enforced.

“[I]f you care about the ACA, then you’ll want us to take the fraud out,” he underscored. “And let me just take a step back. If we want you to go back to work on Medicaid, what’s going to happen? You’re going to start making money. As you make money … you get above the poverty level. You’re going to want to buy an Affordable Care Act product or a private industry [plan]. Commercial insurers are going to start using it. That’s a good thing. We’re getting America back up. They’re getting [Medicaid recipients] into work, getting them into the stratosphere, building prosperity. So we want these programs to work together. But if you’ve got millions of people literally who are getting insurance that they don’t want, they don’t even know they have it, and we’re all paying for it, that’s tens of billions of dollars we’re throwing away. That increases premiums for everybody. It drives affordability down.”

“We’re not going to tolerate [it] anymore,” Oz added.

AUTHOR

Dan Hart

Dan Hart is senior editor at The Washington Stand.

EDITORS NOTE: This Washington Stand column is republished with permission. All rights reserved. ©2026 Family Research Council.

The Washington Stand is Family Research Council’s outlet for news and commentary from a biblical worldview. The Washington Stand is based in Washington, D.C. and is published by FRC, whose mission is to advance faith, family, and freedom in public policy and the culture from a biblical worldview. We invite you to stand with us by partnering with FRC.