July 18, 2025

Victims of Biden’s Enrollment-At-Any-Cost Exchange Strategy

Gabrielle Kalisz

Program Manager

Gabrielle “Elle” Kalisz is the Program Manager at Paragon Health Institute. Gabrielle has worked in federal health policy for over five years, advancing free-market principles and partnerships.

It was a harmful combination: President Biden’s enrollment-at-any-cost policy combined with his American Rescue Plan Act’s enhanced COVID subsidies. The two policies led to massive improper enrollment in the Obamacare exchanges. As a result, millions of Americans were enrolled against their will in multiple plans, jeopardizing both their health access and financial stability.

Paragon conducted a careful empirical analysis and estimated that at least 6.4 million people are enrolled who claim income low enough for a fully subsidized plan but do not actually have that income. The Biden policies created huge incentives for unscrupulous brokers to cheat, as they generated higher commissions from boosted enrollment. Insurers also benefited from fraud and improper enrollment through much higher government subsidies and received no financial penalty for improper enrollments.

Fortunately, the Trump administration has taken regulatory action. The administration is ensuring that people are eligible for coverage, and unscrupulous brokers cannot game the system as in years past. By enacting the One Big Beautiful Bill (OBBB), Congress codified President Trump’s program-integrity rules, further improving long-term program integrity across the nation.

On July 17, the Centers for Medicare & Medicaid Services identified 2.8 million people enrolled in multiple types of subsidized coverage, including 1.6 million who were doubly enrolled in both Medicaid and a subsidized exchange plan. Many victims with employer-sponsored insurance face immense tax penalties after being enrolled without their consent into a subsidized Obamacare plan.

Patients have also been switched into plans they did not choose or want, losing access to needed doctors and accumulating tax liabilities. Unauthorized enrollment and plan switching have negatively impacted both access to care and quality of life for victims who face a disproportionate share of penalties associated with ACA fraud. Paragon details anonymous testimonials and the logistical mechanics from brokers, tax planners, and victims in Unpacking the Great Obamacare Enrollment Fraud: How the Exchanges Became the Wild West. A recent Bloomberg News exposé quotes agents saying half of enrollees had no idea they were signing up. One broker said, “You have to throw away a little bit of your morality.”

Below are public accounts and media highlights from across the United States detailing the immense emotional, physical, financial, and logistical burden faced by victims of ACA fraud:

Ashley Zukoski of North Carolina had employer-sponsored insurance but now faces a $700 tax penalty instead of a $4,100 refund as a result of being enrolled in a fully subsidized ACA plan without her knowledge. (July 2024)

“A broker in Florida enrolled her family in an ACA plan in late February 2023, even though Zukoski had coverage starting that January through her job. The broker listed an income that qualified the household for a full subsidy, so Zukoski never received a premium bill.”
“After reporting the problem to the federal marketplace, she sought to get the 1095-A voided so she would not be liable for the plan’s premium subsidies paid by the government to the insurer. But, because Zukoski’s pharmacy had billed the ACA plan instead of her job-based coverage, her request was denied.”

Michael Debriae of North Carolina was enrolled in an ACA plan without his consent two months after cancelling previous ACA coverage due to receiving employer coverage. Debriae now must pay back the $2,445 in premium tax credits paid to the insurer from less than four months of coverage. (April 2024)

Amy Shepherd of Georgia says her agent and plan were switched three times without her consent. She was also bombarded with calls in hundreds of additional attempts to switch her plan. (July 2024)

“Even worse, she said, are the multiple calls she gets daily, at all hours, from other agents apparently trying to persuade her to switch plans.”
“‘These spam calls are stressing me beyond words,’ said Shepherd, who wants to remain in her current plan and has enlisted the help of a friend, who happens to be an insurance agent, to help.”

Conswallo Turner of Texas responded to an ad on Facebook that promised cash gift cards, and a sales agent switched her plan, even dropping her son from coverage entirely. (July 2024)

“She ended up with a higher-deductible plan along with medical bills for her now-uninsured son, the lawsuit alleges. Her actual agent also lost the commission. The lawsuit contains similar stories from other plaintiffs.”

Angela Wells of Texas responded to an ad that promised cash cards for groceries. Even though she refused to sign up for insurance over the phone, the agent switched her plan anyway. Under her new plan, her co-pay for her diabetes medications went up from $2 to $50 a month and delayed access to life-saving prescriptions. (September 2024)

“I didn’t know what was going on. I just know I went to get my medicine and my insurance was canceled,” said Wells, a plaintiff in the suit filed in U.S. District Court in Fort Lauderdale, Fla.”

Crystal Bedford of Georgia was improperly enrolled in the ACA even though she already had employer coverage. She only found out when she received an unexpected tax bill notifying her that she had been enrolled in coverage and would now owe $7,500. (April 2025)

“The government had paid almost $10,000 in premiums for me, and my heart dropped,” Bedford said. “It said I was gonna owe back $7,500 and I—I just—I lost it.”

Lorie and Randy Delaney of Ohio had their ACA Marketplace health insurance plans repeatedly changed without their knowledge and faced thousands of dollars in additional prescription costs. Lorie enrolled them in a Marketplace plan while working as a contractor. (November 2024)

They realized something was wrong when Randy’s insulin prescription cost $1,096—far more than expected.
Lorie contacted the Marketplace and learned their plan had been changed from Medical Mutual to United Healthcare by an insurance broker in Texas they had never interacted with.

Tiesha Foreman of Georgia had been enrolled in multiple health insurance policies by brokers she had never contacted and was denied care from her daughter’s pediatrician who was no longer in network as a result of plan switching. (November 2024)

“For three months, I kept trying to call on the phone, trying to talk to the marketplace to get them to understand I wasn’t doing these applications”

Ashley Akra of North Carolina and her family, covered under employer sponsored insurance, discovered they were signed up for an ACA Marketplace plan without their knowledge in February 2023 when her newborn daughter was denied coverage for medication at the pharmacy. The Arkas later paid tax penalties as a result. (November 2024)

Ashley said she learned they had been enrolled in a different plan—not the employer-based plan she was using—and that it included a full government subsidy. She stated, “Our newborn needed medication… that’s how we found out.”

Callie Navrides, a licensed insurance agent and plaintiff in a class action lawsuit, reported that her clients were switched into different ACA plans without her knowledge. She believes consumer data was collected through online pop-up ads offering ”free money” and then misused by rogue brokers. (November 2024)

Navrides said it happened “over and over and over again,” including a dozen times for a single client. Navrides explained that brokers could hijack coverage using only a consumer’s first name, last name, date of birth, and state.