Staff Reports
The federal government just dropped a report that should make every taxpayer sit up: Health and Human Services’ own analysts say millions of Affordable Care Act exchange enrollments were improper or “phantom” accounts, and more than 1 million people are listed without a Social Security number. Health and Human Services Secretary Robert F. Kennedy Jr. and Centers for Medicare & Medicaid Services Administrator Dr. Mehmet Oz put out a joint video this week saying they will hunt down the bad actors. That alone ought to settle the argument: this is a problem of system failure, not a mystery.
What HHS found
The HHS Office of the Assistant Secretary for Planning and Evaluation (ASPE) produced a short but damning brief. It estimates that improper, phantom, or fraudulent participation in ACA exchanges peaked at roughly 5.6 million people in 2025 and that about 2.6 million questionable enrollments remain. Most striking: the agency reports “over 1 million enrollments without a Social Security number.” These are HHS’s own estimates, based on administrative data and modeling — and the agency says it has already removed or blocked millions from receiving improper subsidies.
Key numbers from the ASPE brief
ASPE’s brief cites about 19.2 million current marketplace enrollees, peak improper participation near 5.6 million, and an estimated 2.6 million remaining questionable cases. The single line that should alarm every elected official: more than one million enrollments have no Social Security number on file. That is not a clerical quirk — it is an open invitation for fraud.
How this happened
The brief points to a run of temporary rules and looser verification between 2021 and 2024 that created gaps. Expanded special‑enrollment windows and weaker ID checks opened the door for “phantom” enrollments, income‑misstatements, and fraud. Critics will also note the end of enhanced premium tax credits and rising premiums pushed some enrollment numbers down for affordability reasons. Fair point. But relaxed verification and policy changes made the marketplace a lot easier for scammers to exploit — and taxpayers paid the bill.
Why taxpayers should care — and what the administration is doing
Taxpayers should care because this is about money, trust, and basic fairness. The ASPE numbers imply billions in improper subsidies over time — and that hurts honest Americans and states scrambling with health budgets. Secretary Robert F. Kennedy Jr. and Administrator Dr. Mehmet Oz didn’t sugarcoat it in their video: they said they’re exposing how bad actors exploited the marketplace and promised enforcement. Good. Talk is cheap; we need prosecutions, clawbacks, and stronger verification now. If someone’s stealing your tax dollars through phantom Obamacare accounts, “we will find you” shouldn’t be a publicity stunt line — it should be a promise with teeth.
What must happen next
Start by treating the ASPE brief as a wake‑up call, not a partisan trophy. Inspect the methodology, demand the data, and let independent analysts verify the scope. Then lock down verification rules so phantom enrollments are impossible, not just harder. Follow the money: pursue civil recoveries and criminal charges where evidence supports it. And finally, have an honest debate about program design. Big entitlement programs invite big waste. If Washington wants to keep taxpayers on the hook for health subsidies, it must stop pretending the system can run without rigorous checks. Otherwise, expect more headlines — and more of your money gone missing.
