Senate Republicans are urging the Department of Justice (DOJ) to recover many millions of dollars in fraudulent Obamacare subsidy payments made during the Biden administration.
In a letter sent Wednesday to Assistant Attorney General Brett A. Shumate of the Civil Division, the 14 GOP senators, led by John Cornyn of Texas, condemned rampant fraud in the Affordable Care Act (ACA) marketplace and urged the department to act. They cited widespread abuses, including fake identities and improper payments, as evidence that taxpayer dollars are being funneled to insurers on behalf of ineligible or even deceased individuals.
“[T]he federal government has a duty to ensure that the associated ACA marketplace subsidies paid directly to insurance companies are properly recouped,” the senators wrote in the letter obtained first by the Daily Caller News Foundation. “I urge you to evaluate civil remedies to recover ACA subsidy payments made to insurance companies due to waste, fraud, and abuse. Americans deserve to know that their taxpayer dollars are not being spent in furtherance of fraudulent ACA marketplace enrollment schemes.”
Enhanced Obamacare subsidies became a political flash point in 2025, triggering a record government shutdown after Democrats refused to extend expiring premium subsidies.
The subsidies were originally limited to households earning between 100% to 400% of the federal poverty level. However, Democrats in 2021 removed the upper-income cap and increased the subsidies to cover a higher share of premiums and, in some cases, reduced certain households’ premiums to zero, without a single Republican vote.
A December report from the Government Accountability Office (GAO) revealed that fictitious identities, invalid Social Security numbers, and even deceased individuals were routinely approved for taxpayer-funded ACA subsidies.
Among the findings, 58,000 Social Security numbers receiving benefits in 2023 matched death data, resulting in $94 million in taxpayer subsidies being sent to insurers on behalf of deceased individuals. The GAO could not identify evidence of reconciliation for over $21 billion in ACA marketplace subsidies in 2023.
Critics have long warned that zero-premium plans create opportunities for fraudsters to enroll unsuspecting individuals without their knowledge.
Between January and August 2024, the Centers for Medicare & Medicaid Services received roughly 275,000 complaints from consumers who were enrolled in a plan or had their plans changed without their consent.
High-profile cases include a Florida executive who in April of 2025 pleaded guilty to submitting fraudulent applications for fully subsidized ACA plans, resulting in at least $133.9 million in improper federal payments.
In November 2025, a brokerage firm president and a marketing executive were convicted of their roles in a $233 million fraudulent ACA enrollment scheme, under which at least $180 million in subsidies were paid to insurers.
“While I am encouraged by the DOJ’s recent criminal convictions of certain brokers and agents in connection with fraudulent enrollment schemes, the federal government has a duty to ensure that the associated ACA marketplace subsidies paid directly to insurance companies are properly recouped,” the group wrote.
The senators also pressed the DOJ on what steps it is taking to recover taxpayer dollars tied to fraudulent enrollments. They asked whether the department is pursuing cases under the False Claims Act or claims of unjust enrichment against insurers, and what other avenues might be available to reclaim the funds.
They also requested details on how many civil investigations have been opened since April 2021 into fraudulent enrollments, misrepresentations of subsidy eligibility, or false identities.
The DOJ did not immediately respond to the DCNF’s request for comment.
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