Taxpayers spent $65 billion on health insurance premiums for people who either didn’t exist or didn’t qualify for benefits in two federal programs in 2024, according to an Aug. 26 report from Paragon Health Institute.
Expanded Medicaid and Obamacare, the signature programs of the Affordable Care Act, improperly enrolled a combined 14.3 million people that year, researchers concluded.
Expanded Medicaid allows states to enroll people making up to 138 percent of the federal poverty level, versus up to 100 percent for traditional Medicaid. That limit was about $35,600 for a family of three in 2024.
Obamacare was open to people earning up to 400 percent of the federal poverty level at that time, about $103,000 for a family of three.
Both programs are administered through the Affordable Care Act Marketplace, with coverage provided by commercial insurance companies.
As Lawrence Wilson details below, via The Epoch Times, researchers estimate that about 34 percent of all Marketplace enrollees in 2024 were either fraudulent, duplicates, or simply didn’t meet the benefit criteria.
And the number went up the next year, researchers said.
“Improper exchange enrollment increased by more than 26 percent from 2024 to 2025 – up to an estimated 6.5 million enrollees,” the report stated.
Enrollment Problems
Researchers studied federal data from surveys, program enrollment, and spending and concluded that more than 9 million Medicaid expansion enrollees in 2024 probably didn’t qualify for the benefit.
Those were likely people whose income was over the limit, did not meet citizenship, immigration, or residency requirements, or should have been enrolled in traditional Medicaid.
With Obamacare, the $0 premium policies made possible during the post-COVID years became a target for fraud, according to Paragon President Brian Blase.
Testifying before Congress in December, Blase said many people were enrolled in the program without their knowledge by unscrupulous insurance brokers, prompting the federal government to send a commission check to them – and premium payments to an insurance company.
These phantom enrollees are detected in part by their lack of activity once enrolled, Blase said.
Also, 28 states had more people enrolled in Obamacare than there were people in the state who met the income requirements.
Hellbound and Down 