US Senator James Lankford (R-OK), who chairs the Border Management, Federal Workforce, and Regulatory Affairs Subcommittee of the Homeland Security and Governmental Affairs Committee, brought attention to findings from the Government Accountability Office (GAO) during a recent hearing. The session examined federal programs considered high-risk or fragmented, with part of the discussion focused on GAO’s investigative work into identity verification failures in the Affordable Care Act’s federal health insurance marketplace.
Lankford is continuing oversight efforts aimed at preventing waste, fraud, and abuse in federal benefit programs. He emphasized the importance of basic safeguards to verify identity and eligibility before taxpayer funds are spent.
During the hearing, Lankford referenced GAO’s evaluation: “… I want to go to some of the testing that GAO did on the Affordable Care Act. And they did some quick evaluation to be able to say, ‘Can you get into the system and actually sign up for this and not be a person on it?’ My understanding is that for 24 different individuals that were fraudulent, individuals that were created to be able to test the system, the results were pretty stark on this…”
A representative from GAO clarified: “So, good morning, Senator Moreno, Chairman Lankford… So the actual number is 20 scenarios. We started with four in late 2024. We rolled those over, and we added 16 more to our total. This is based on a comprehensive investigative plan. It is designed specifically to test controls, not project the extent of fraud. So, I want to be very clear, specific about that.”
The investigation focused solely on applications through HealthCare.gov and brokers identified both via official channels and random online searches. According to GAO: “We are focusing on the federal marketplace. And those 20 scenarios involve ten application actions through HealthCare.gov and ten through brokers, which we selected through the website itself and also through random research on Google.” Fourteen scenarios involved single individuals enrolled at no cost; six required payment of modest premiums.
GAO reported high rates of success when submitting false information: “We have been successful in 19 of 20 attempts. One attempt was later flagged by CMS in June of this year…But we do have 18 of them that cost the government over $10,000 a month in premiums. We will continue to roll them over and monitor what happens from CMS.” When asked if these cases remained active at present time: “They are, as we speak, 18 of the 20 are active.”
Lankford questioned whether fabricated names or documents were used: “So my question to you on this is, is this false Social Security numbers or is this multiple Social Security numbers… So is this a fake name and fake everything?” The response from GAO was direct: “Everything is fake, sir. All the information—driver’s license, Social Security number, pay stubs, birth certificates—anything and everything that the marketplace has asked us to submit is fake.”
The issue extended beyond testing scenarios into real data within program records as well. Lankford stated his understanding about repeated use of identical Social Security numbers among actual enrollees—not just test cases—and sought details about such instances.
GAO described one example: “Yeah…I will highlight…the most egregious one we have…127 policies attached to a single number that’s costing…the government about $600,000 a year in subsidies…and…the critical point is…the 33 full-year policies are spread across 13 different states…and they involve a mix of genders…that something isn’t right here.”
Lankford expressed concern regarding Centers for Medicare & Medicaid Services’ (CMS) response when such anomalies surfaced: “You would think that you would notice that same Social Security number has multiple genders and lives in multiple states?”
GAO replied: “Yes. And when we pressed CMS on that…their response is ‘We really are not going do anything because we don’t want kick off wrong person…’”
Lankford concluded simply: “Well—that’s a problem.”
