A newly released report from the U.S. Government Accountability Office (GAO) has raised fresh concerns about vulnerabilities in the Affordable Care Act (ACA) or Obamacare marketplace, identifying weaknesses in identity verification and account security that investigators say left the system susceptible to fraud and unauthorized account activity.
The findings come as the Trump administration steps up efforts to tighten oversight of the federal health insurance marketplace. Republican lawmakers have also pointed to the report as evidence that stronger safeguards are needed to protect consumers and curb improper spending.
According to the GAO, deficiencies in identity verification and account protection created opportunities for bad actors to exploit the marketplace. Investigators found that weaknesses in existing controls could be used to facilitate fraudulent enrollments and unauthorized changes to consumer accounts.
The report also highlighted the impact on legitimate enrollees. Investigators estimated that as many as 160,000 marketplace consumers may have had changes made to their accounts without their knowledge, in 2024, leading to unauthorized plan switches and enrollment modifications.
“This investigation found as many as 160,000 people using the program legitimately had their accounts accessed and changed without their permission,” Fox Business correspondent Connor Hanson said while reporting from Capitol Hill.
The report has added momentum to congressional Republicans’ broader review of spending and oversight within the Affordable Care Act marketplace.
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During the Fox News broadcast, Hanson said the House Energy and Commerce Committee estimates that roughly $27 billion in improper payments have been made through the marketplace, while noting that the figure reflects the committee’s assessment rather than a GAO estimate.
“One House committee estimates around $27 billion in improper payments are going to people taking advantage of this system,” Hanson said during the broadcast.
In its review, the GAO concluded that existing protections were not sufficient to prevent identity-related fraud or unauthorized enrollment activity.
“A lack of basic safeguards allows bad actors to use fake identities, other people’s Social Security numbers and even dead people to receive subsidies,” Hanson said, summarizing the report’s findings.
Beyond identity verification issues, the watchdog examined the role of insurance agents and brokers, who assist consumers with enrolling in marketplace coverage. While recognizing that brokers are an important part of the enrollment process, the GAO said recent criminal prosecutions demonstrate that some agents enrolled consumers or switched their health plans without obtaining authorization.
The report warned that unauthorized enrollment changes can leave consumers facing unexpected medical bills, tax liabilities, interruptions in prescription drug coverage, and the loss of access to preferred physicians and healthcare providers.
To address these vulnerabilities, the GAO recommended that the Centers for Medicare & Medicaid Services improve identity verification protocols and add further security measures to guard against unauthorized account takeovers and enrollment changes.
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House Energy and Commerce Committee Chairman Brett Guthrie placed responsibility on the previous administration’s handling of the marketplace.
In a statement cited by Fox News, Guthrie said: “The Biden-Harris administration actively removed safeguards protecting Americans from unscrupulous actors taking advantage of them, including unauthorized enrollments and switching Obamacare plans.”
The report also comes as the Trump administration advances broader anti-fraud initiatives across federal health programs. According to the Fox News report, the administration said last month that it is removing millions of fraudulent enrollments from the Obamacare marketplace as part of an effort to strengthen program integrity and ensure taxpayer-funded subsidies are directed to eligible recipients.
While the GAO did not call for changes to the Affordable Care Act itself, it urged federal officials to strengthen security controls, improve identity verification practices, and enhance consumer protections to better safeguard marketplace accounts and reduce opportunities for fraud.