The U.S. General Accounting Office tested the federal marketplace of the Affordable Care Act, creating fictitious applicants and seeing if the Centers for Medicare & Medicaid Services would sniff out the fact that the applicants did not exist.
I know it’s going to shock you, but the fraud was not detected.
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The federal Marketplace approved subsidized coverage for all four of GAO’s fictitious applicants submitted in October 2024. In total, the Centers for Medicare & Medicaid Services (CMS) paid about $2,350 per month in APTC in November and December for these fictitious enrollees. For some, the federal Marketplace requested documentation to support Social Security numbers (SSN), citizenship, and reported income. GAO did not provide documentation yet received coverage.
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Plan year 2025. Of 20 fictitious applicants, 18 remain actively covered as of September 2025. APTC for these 18 enrollees totals over $10,000 per month. GAO continues to monitor the enrollments as part of its ongoing work.
Come on, CMS. Even the TSA catches some of the test bombs.
So if that $10,000 a month for those fictitious enrollees goes to the U.S. GAO fraud detection team . . . that money does eventually go back to the U.S. Treasury Department, right?
Remember, congressional Democrats insist it is extremely important to maintain the previous level of subsidies, and it’s the sort of thing that makes the longest federal government shutdown ever worth it. Without subsidies, imagine how the Fictitious-American community will suffer.