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PULSE POINTS
âť“WHAT HAPPENED: House Republicans, led by Judiciary Committee Chairman Jim Jordan (R-OH), are investigating potential fraud by major Obamacare health insurance brokers, citing concerns over soaring program costs.
👤WHO WAS INVOLVED: The House Judiciary Committee, Blue Shield of California, Centene Corporation, CVS Health, Elevance Health, Kaiser Permanente, Oscar Health Inc., and GuideWell.
đź“ŤWHEN & WHERE: Letters were sent on Monday, December 15, 2025, as part of an ongoing investigation into Obamacare-related fraud.
💬KEY QUOTE: “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.” — House Judiciary Committee letter
🎯IMPACT: The investigation could influence whether Obamacare’s enhanced premium subsidies are extended or allowed to expire, amid concerns of fraud and inefficiencies.
IN FULL
House Republicans are launching a probe to determine whether some of the nation’s largest health insurance brokers are contributing to rampant fraud plaguing Obamacare. With federal subsidies for Obamacare set to expire at the end of December, conservative lawmakers on Capitol Hill contend the healthcare program’s soaring costs are, at least in part, due to fraudulent claims enabled by insurance brokers.
On Monday, the House Judiciary Committee, chaired by Congressman Jim Jordan (R-OH), issued notices to Blue Shield of California, Centene Corporation, CVS Health, Elevance Health, Kaiser Permanente, Oscar Health Inc., and GuideWell, requesting detailed data and other documentation regarding their enrollment operations. These companies administer programs that assist consumers in signing up for Obamacare’s enhanced health insurance premiums, which are central to the committee’s fraud concerns.
“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,” the committee wrote.
Of particular interest to the House Judiciary Committee is data regarding the number of individuals enrolled in enhanced premium tax credits and the number of enrollees who do not utilize their benefits. Additionally, the committee is requesting all internal communications related to fraud and abuse, as well as a list of employees involved in anti-fraud initiatives.
The National Pulse reported earlier this month that a Government Accountability Office (GAO) audit found that tens of thousands of Social Security Numbers (SSNs) were used fraudulently in recent years to claim insurance coverage with advanced premium tax credits. According to the GAO, 58,000 SSNs that received advanced premium tax credits matched Social Security death data. Of these, at least 7,000 individuals were confirmed to have died before their coverage began. Investigators also created fictitious identities using fake or never-issued SSNs, all of which were approved for subsidized Obamacare coverage.
Image by Gage Skidmore.
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