In The Persistent Obamacare Enrollment Fraud, we estimated 6.2 million improperly enrolled Obamacare enrollees after the 2026 open enrollment period. We define improper enrollment as the number of enrollees claiming income in the 100-150 percent Federal Poverty Level (FPL) group that exceeds the number of potential enrollees that plausibly have that income. Enrollees claiming income in the 100-150 percent FPL group receive the largest subsidies, with most of them qualifying for zero premium bronze or gold plans as well as heavily discounted silver plans. These “free” plans create strong incentives for brokers and other intermediaries to place consumers into the 100–150 percent FPL group, even when applicant income or eligibility information does not support that classification. Insurers receive more subsidy dollars and brokers receive greater commissions. Large scale improper enrollment has also led to significant number of phantom enrollees in the exchanges.
The enrollment data continue to show the scale of the problem. As this Paragon PIC shows, HealthCare.gov enrollment remains far above 2020 levels, with the largest increase concentrated in the 100–150 percent FPL group. Enrollment in this category rose from about 3 million during 2020 open enrollment to more than 10 million during 2026 open enrollment. Of the total enrollment increase from 2020 to 2026, approximately 67 percent was in the 100-150 percent FPL group.
