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Experts Decry $20 Billion in Fraudulent Obamacare Claims


By: Nolan McKendry | The Center Square

Though the 2024 presidential election campaign cycle is well underway, health care issues have so far been overshadowed by other topics.

The upcoming four years will be pivotal for addressing a wide array of health care issues, such as lowering prescription drug costs, increasing transparency and easing navigation of the US’ complicated health care system.

Experts at the American Enterprise Institute argue that the Biden administration’s health care incentives for lower income individuals are making health care more expensive and costing taxpayers billions of dollars.

“Overall, we estimate there's 4 to 5 million people fraudulently enrolled in Obamacare plans,” said Brian Blase, President of Paragon Health Institute. “The cost to taxpayers is likely north of $20 billion, just this year.”

The group debuted a study done by Paragon which elaborated on the extent to which people are receiving free health care by falsifying their income statements.

The Biden Administration greatly expanded subsidies for people through Obamacare, offering people health care at no cost if they report income between 100% and 150% of the federal poverty line.

Many individuals took advantage, Blase says, purposefully underestimating their income so to receive free care. According to Paragon’s study, claims from individuals within that poverty bracket rose by 13%, from 2022 to 2024.

“This is a very sophisticated operation that’s occurring, that’s been enabled by the Biden administration’s focus on enrollment in the exchanges above all else, and a political imperative to get more people enrolled to the extent that their not verifying eligibility,” Blase said.

With questions over Medicare’s solvency, spending accountability is important than ever.

Members of the AEI panel stipulated that they expect Obamacare to be here to stay.

“I think there’s ways to deal with Obamacare that will help people that have been harmed but leave the general structure of Obamacare alone,” Blase said.

Blase argued that a new approach where low-income individuals can have a say in how their health subsidies are utilized would be useful.

“Instead of the subsidy going to the insurance company for the insurance company to reduce plan-deductibles and out-of-pocket limits, the enrollee would get an actuarial equivalent amount, in a health savings-like account and they would actually control it,” Blase said, describing an option offered to enrollees from Paragon.

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