Join the Paragon Health Institute for a critical discussion of the growing improper enrollment and spending in the Affordable Care Act (ACA) exchanges, based on findings from Paragon’s latest report, The Greater Obamacare Enrollment Fraud. We will also discuss key findings in our report, Unpacking The Great Obamacare Enrollment Fraud, and a recent Prognosis post, The Rise of Phantom Obamacare Enrollees.
This virtual event will examine how Biden administration policies, particularly enhanced subsidies and lax verification, allowed millions of ineligible individuals to receive fully subsidized exchange plans, at a staggering cost to taxpayers.
Key issues to be discussed:
- Nearly half of 2025 enrollees claimed incomes between 100 percent and 150 percent of the federal poverty line (FPL) to qualify for fully subsidized plans with very low deductibles and cost-sharing. Paragon estimates that this fraud cost taxpayers $27 billion in 2025 alone.
- Paragon estimates that improper enrollment—defined as enrollees who claimed, but did not actually have, income between 100 percent and 150 percent FPL—increased from 5.0 million enrollees in 2024 to 6.4 million enrollees in 2025.
- How unscrupulous brokers, agents, and insurers exploit incentives to inflate or misstate income on applications, and how the problem was particularly severe in states using the federal exchange.
- The dramatic rise in enrollees who don’t use any medical services and phantom enrollees—those who are unaware of their coverage or are also enrolled in other coverage.
We will also review real-world impacts of the improper enrollment and spending, positive policy actions in the One Big Beautiful Bill to reduce the abuse and fraud, and make recommendations related to ACA subsidies.
Panelists:
- Brian Blase, PhD, President, Paragon Health Institute
- Gabrielle Kalisz Minarik, Program Manager, Paragon Health Institute
📩 We encourage you to share this invitation with colleagues working on ACA policy, Medicaid reform, or program oversight.
