
Dr. Mehmet Oz, administrator of the Centers for Medicare & Medicaid Services, says fraud tied to the Affordable Care Act has cost taxpayers millions of dollars, describing it as a serious abuse of the federal health insurance exchange system. The issue involves brokers and agents who allegedly manipulated enrollment records to collect government subsidies and commissions tied to Obamacare plans. The activity allowed some agents to sign individuals up for coverage without their knowledge or switch their plans without consent. Those actions triggered federal subsidy payments that should never have been issued.
Advertisement
In an interview with NBC News, Oz said some people on ACA plans should not be enrolled and expects the enrollment rate will continue to fall to around 19 million.
“In fact, the fact that we have 23 million makes me think we have too many participants in the ACA,” Oz told the outlet. “It’s too high a number.”
Oz said he believes some sign-ups are the result of fraud or mistakes.
“Either their income would not qualify them, they made too much or made too little, or they didn’t file the forms, maybe on purpose, or they were duplicately enrolled in Medicaid or more likely other states’ ACAs,” he added. “These are major concerns for us.”
Oz now oversees the agency responsible for administering federal health programs, including Medicare, Medicaid, and the Affordable Care Act marketplace. During remarks on the problem, Oz stated that fraudulent enrollments and unauthorized changes to insurance policies resulted in significant financial losses for the federal government. Oz also warned that the system's structure made it easier for dishonest brokers to exploit weaknesses in the enrollment process. Federal officials have begun tightening verification requirements to prevent additional abuse.
Obamacare became law in 2010 under President Barack Obama and created online marketplaces where Americans could purchase insurance plans and receive federal income-based subsidies. Federal agencies distributed billions of dollars in premium tax credits to help eligible participants offset costs. Oversight challenges have persisted since the program's launch. Fraud investigations have targeted both insurance agents and organized schemes attempting to collect federal payments tied to false enrollments.
Advertisement
Federal law enforcement agencies have already brought criminal cases involving fraudulent health insurance enrollments tied to government subsidy payments. Several investigations focused on agents who created fake accounts or moved consumers to different plans to generate commissions; those cases demonstrated how vulnerable the system can become when large subsidy payments move through private brokers. Officials have attempted to improve monitoring systems, though problems continue to surface.
Members of Congress have also raised concerns about oversight gaps. House Energy and Commerce Committee Chairman Brett Guthrie (R-Ky.) has pushed for stronger safeguards protecting consumers from unauthorized policy changes. Lawmakers argue that Americans should never discover that their insurance coverage has been altered without their consent. Federal regulators are reviewing enrollment procedures to reduce the risk of manipulation by dishonest brokers.
The broader debate surrounding Obamacare has never disappeared. Supporters argued that the law expanded insurance access for millions of Americans, while the rest of us thought it was a whole bunch of waste, abuse, and a complete crock.
Oz's warning about fraudulent enrollments adds another layer to that long-running dispute. Americans were promised transparency, accountability, and efficient management of taxpayer funds.
Yet the discovery of fraudulent enrollments raises uncomfortable questions about how closely the system has been monitored. When large federal programs distribute billions of dollars through online exchanges and private brokers, even small vulnerabilities can create major financial exposure. Fraud tied to Obamacare may represent only a portion of broader oversight challenges facing federal health programs.
Advertisement
Americans deserve clear answers about how those vulnerabilities developed and how much money was lost to fraudulent enrollments. Federal agencies now face pressure to prove they can close those gaps. Otherwise, skepticism toward government-managed health programs will continue to grow.
Ever wonder what else the Democrats have been saying that's false?
PJ Media VIP gives readers deeper analysis without the political spin that dominates national headlines. A VIP membership unlocks exclusive articles, podcasts, and community discussions across the entire network. Right now, readers get 60% off a subscription using promo code FIGHT.

