WASHINGTON, D.C. — A sweeping new report from the Government Accountability Office (GAO) reveals that the Affordable Care Act’s enhanced premium subsidies — expanded during the COVID-19 pandemic — are being paid out to tens of thousands of questionable or outright bogus accounts, including duplicate Social Security numbers, deceased individuals, and applicants who provided no identification at all.

The watchdog’s findings land squarely in the center of a fierce congressional battle over whether to extend the temporary subsidies before they expire at year’s end.

29,000 Duplicate SSNs in 2023 — and 68,000 in 2024

GAO investigators found large patterns of irregularities in how the federal insurance Marketplace flags questionable accounts.

Among the most striking:

29,000 SSNs were used to obtain more than one year’s worth of coverage in 2023

Nearly 68,000 SSNs were used the same way in 2024

This means Obamacare was paying premium tax credits for multiple plans tied to the same identity in a single year — something that is supposed to trigger immediate verification.

And in some cases, the individuals tied to the SSNs weren’t alive.

GAO found over $94 million in premium tax credits (APTCs) in 2023 went to SSNs belonging to deceased individuals.

Fake Applicants Easily Exploited Obamacare — and Are Still Enrolled

To test system vulnerabilities, GAO created 20 fictitious accounts using fabricated:

Names

Addresses

Citizenship status

Income

Social Security numbers (or none at all)

18 out of 20 fake applicants were approved for Obamacare coverage and remain actively enrolled, collectively receiving over $10,000 per month in subsidies.

GAO emphasized this fraud cannot be extrapolated to the entire population — it accounts for less than 1% of enrollees — but the ease with which the watchdog bypassed verification alarms lawmakers in both parties.

$21 Billion in Subsidies Unmatched to Tax Records

Another major red flag: GAO found accounting gaps on the back end.

In reviewing 2023 IRS and Marketplace data, GAO “could not identify evidence of reconciliation” for more than $21 billion of advance premium tax credits paid to enrollees who submitted SSNs.

Under law, APTCs must be reconciled through tax filings. Without that, the government cannot confirm whether enrollees received the correct subsidy amount — or were even eligible at all.

Why This Happens: “Flexibility” and System Gaps

Marketplace officials defended some anomalies, telling GAO that multiple enrollments under the same SSN are permitted in cases of:

Identity theft

Data entry mistakes

Urgent access needs

But investigators said the system failed to distinguish legitimate errors from obvious fraud, allowing both to slip through.

In several test cases, applicants who never submitted any documentation were approved anyway.

Political Fight: To Extend Subsidies or Let Them Expire?

The timing could not be more contentious.

The expanded subsidies — first passed during the pandemic — are set to expire this month unless Congress votes to extend them. More than 90% of Obamacare’s 24 million enrollees rely on the enhanced subsidies.

Democrats warn premiums could spike overnight if Congress fails to act.

Republicans, divided on extending the subsidies, say the GAO report validates long-standing concerns that federal health programs are bloated and easily exploited.

Continuing the subsidies in their current form would cost the government over $30 billion a year, per the Committee for a Responsible Federal Budget.

A Senate vote on a three-year extension is expected this week — and is widely predicted to fail.

Bigger Picture: Fraud Is Small but Symbolically Explosive

GAO repeatedly stressed that detected fraud is less than 1% of ACA enrollees and cannot be generalized.

Still, the political optics are powerful:

Bogus accounts thriving

Dead people receiving subsidies

Duplicate SSN enrollments

Fake identities getting free coverage

… all while lawmakers argue over whether taxpayers should continue footing the bill for a pandemic-era program now entering its tenth year.

The Department of Health and Human Services did not respond to requests for comment.