On June 20, 2024, Paragon’s data brief on Obamacare fraud titled “The Great Obamacare Enrollment Fraud,” by Brian Blase and Drew Gonshorowski, was recently referenced in Politico.
From the article:
An estimated 5 million people who received premium health insurance subsidies don’t meet qualifications for them, per a report by right-leaning health policy think tank Paragon Health Institute.
Background: Enhanced premium subsidies, which lower or eliminate the cost of out-of-pocket premiums for people who report income between 100 and 150 of the federal poverty line, are available through 2025 under provisions in the American Rescue Plan Act and the Inflation Reduction Act. President Joe Biden has called on Congress to further extend those subsidies.
According to the Paragon report, nearly half of the exchange sign-ups during the 2024 enrollment period reported income levels that qualified enrollees for subsidies. But the group said not everyone who reported those income levels actually qualify, equating to an estimated $20 billion in improper spending in 2024.
How we got here: According to the report, enrollees estimate their income for the following year when signing up for a plan, with a reconciliation process later when a person files their taxes. But the IRS is limited in the amount it can recoup from people whose income no longer qualifies them for an enhanced subsidy.
The full article can be found in Politico.
