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| If you stop paying for your ACA plan, do you exist? |
Now cometh Brian Blase and his colleagues from the right-wing Paragon Health Institute with his third iteration of the so-called “Great Obamacare Enrollment Fraud” (rechristened “The Persistent Obamacare Fraud”) — this time claiming 6.2 million “improper” enrollments .
I wanted to get “fraud” and “improper enrollment” in one sentence, because Blase conceptually segues from outright fraud— people enrolled without their consent, or under false pretenses — to “improper” enrollment, which he defines as enrollments in which the applicant’s future-looking income estimate may have been optimized to her advantage — usually by a broker. The original report deemed all enrollments with allegedly massaged income “fraud.”
Paragon’s core claim, which has not changed substantially since the first iteration of this report in 2024, is that the number of enrollees who estimate 2026 income in the 100-150% FPL range — 10.7 million, or 46% of all enrollees — far exceeds the Census Bureau’s survey-based estimates of the eligible population with income in that range. It’s doubtless true that many enrollees optimize their income estimates, usually at a broker’s direction - -e.g., to get over the 100% FPL eligibility thresholds in the 10 states that have not expanded Medicaid (available to adults with income up to 138% FPL in expansion states), or to get below 150% FPL, the eligibility threshold for the highest level of Cost Sharing Reduction (CSR).
