On July 8, 2024, Paragon’s research paper “The Great Obamacare Enrollment Fraud,” by Brian Blase and Drew Gonshorowski, was referenced in a letter from Senator Grassley to HHS and CMS.
From the letter:
On June 20, 2024, the Wall Street Journal reported that, according to a recent Paragon Health Institute study, five million individuals may have falsely reported their income to qualify for Affordable Care Act (ACA), or Obamacare, health-insurance subsidies. The study found that in states not expanding Medicaid, individuals will, either intentionally or accidentally, overestimate their income, allowing them to become eligible to receive these premium tax credits (PTCs). The administration’s failure to ensure the integrity of the program by “seeking to inflate coverage numbers” has cost the taxpayer an estimated $20 billion in 2024.
President Biden signed the Democrats’ 2021 and 2022 reconciliations laws, increasing the subsidies (structured as Advance PTCs) through 2025. The advance PTCs are credited to individuals based on reported income, sent directly to insurers, and can be collected directly by the individuals as part of their tax refund.5 These increased tax credits and reduction in cost-sharing makes health insurance plans fully subsidized for enrollees with an income between 100 percent and 150 percent of the federal poverty level (FPL).
The full letter can be found here.
