Thread by @brian_blase

A teachable moment today for @RepJeffries, who was not aware of the massive amount of improper and phantom enrollment in the ACA exchanges

We summarized the issue here:

Bottom line: 6.4m improper enrollees in '25 & 35% of enrollees with $0 claims

🧵1/xparagoninstitute.org/private-health…

Because of the ACA enhanced subsidies, there was a huge shift in enrollees claiming income for a fully subsidized plan, who did not have that income. This produced windfall profits for insurers

55% of enrollees in federal exchange states claimed income in this narrow band!

2/x

Bloomberg blew the whistle in June: expanded ACA subsidies fueled massive schemes of deception. One insider said half of the “enrollees” didn’t even know they were signed up for health insurance. This is what led to the millions of zero-claim and phantom enrollees. 3/x

We compared people who were eligible (from the Census) with 100-150% FPL sign-ups (for a free plan). In 15 states, there are more than 2x as many enrollees as eligible. In '25, 6.4 million improper enrollees

Not a single policy group on the Left put out its own estimates. 4/x

There have been major indictments alleging massive ACA exchange enrollment fraud and some convictions. We wrote about those cases in our Greater Obamacare Enrollment Fraud report: 5/xparagoninstitute.org/private-health…

What do you expect if there are massive improper enrollees and fraud schemes that enrolled people without their knowledge or consent? One thing would be a massive number of enrollees who do not use their health plan. In August, CMS finally released data. 6/x

35% of enrollees NEVER used their plan in 2024 - no doctor visit, prescription, or lab. And 40% of fully subsidized enrollees had zero claims. These were double the rates from 2021. And despite insurers aggressively advertising 'free' preventive services. 7/xthefederalist.com/2025/10/28/oba…

That's not all. There is a nearly identical figure showing the surge in enrollees with unknown race or ethnicity. This surge is consistent with unscrupulous agents and brokers signing up people without actually knowing them. 8/x

And as a result of automatic re-enrollment provisions, 45% of ACA exchange enrollees in 2025 were just auto-renewed from a previous year. So, the fraud, which really ramped up in 2023 and 2024, was rubber-stamped into the program in 2025. 9/x

The result:
1) A program where rules were not followed, people received excessive subsidies, brokers received excessive commissions, and insurers received excessive revenues.
2) A massive increase of people "covered" but receiving no care.
3) Explosive costs for taxpayers 10/x