A group of 15 Republican senators is turning up the heat on the Department of Justice, demanding a formal investigation into what they describe as a massive drain on taxpayer funds through fraudulent healthcare enrollments.
Led by Florida Senator Ashley Moody and Texas Senator John Cornyn, the coalition sent a pointed letter to the DOJ’s Civil Division this week, calling on the government to aggressively recover Affordable Care Act (ACA) subsidy payments allegedly made based on fake or unauthorized insurance applications.
The crux of the issue dates back to 2021, when the American Rescue Plan Act expanded federal subsidies. This expansion allowed for “$0 premiums” on certain silver-level plans, a move the senators argue created a “gold rush” for unscrupulous insurance brokers.
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According to the letter, these brokers allegedly bypassed consumer consent to enroll people in plans just to pocket the resulting commissions. While the brokers got their fees, the insurance companies received direct monthly subsidy payments from the federal government—payments the senators say were essentially stolen from the public treasury.
Data from the Centers for Medicare & Medicaid Services (CMS) underscores the scale of the confusion, showing roughly 275,000 complaints from consumers who found themselves enrolled in plans or had their coverage switched without their knowledge during the first eight months of 2024.
The senators aren’t just pointing to theoretical risks; they are highlighting a string of high-profile legal battles. They cited a Florida case from last year where an executive admitted to a scheme that cost the government over $133 million. Another conviction in late 2025 involved a brokerage firm president tied to a $233 million fraud ring. In that instance alone, the federal government reportedly paid out $180 million in subsidies directly to insurers for people who weren’t legitimately signed up.
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“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. They are now asking the DOJ for a full accounting of how many civil cases have been opened since 2021 regarding identity misrepresentation and eligibility fraud.
Further complicating the matter is a recent Government Accountability Office (GAO) report. The watchdog agency revealed that the ACA marketplace actually approved nearly all of the “fictitious applicants” submitted by GAO investigators during the 2024 and 2025 plan years. Most strikingly, the GAO noted it could not find evidence of reconciliation for more than $21 billion in marketplace subsidies from the 2023 tax year.
The senators are pushing the DOJ to use the False Claims Act to target insurance companies that may have kept these improper payments. They argue that while criminal convictions for individual brokers are a start, the real money—the billions in taxpayer-funded subsidies—remains in the hands of the insurers and needs to be returned.
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