Medicaid fraud in blue states has dominated headlines recently, but the problem is not new. From its earliest reviews of Obamacare enrollment controls, the Government Accountability Office found that former President Barack Obama’s Affordable Care Act was highly susceptible to fraud. Former President Joe Biden made fraud easier and more lucrative with his COVID-19 subsidy bonuses, and fraud has since exploded, especially in red states that did not build their own online marketplaces. President Donald Trump has taken steps to roll back Obamacare fraud, but a new report from Paragon Health Institute shows the problem is persistent, and more should be done.

Unlike Medicaid fraud, where supposed providers of Medicaid services defraud the government, Obamacare fraud is driven by health insurance brokers. They use online advertisements and purchased consumer data to obtain a minimum of information needed to sign up a real person for health insurance through an online exchange. The brokers fill in income and age information on the applications to game the system so the applicant qualifies for an insurance policy with no monthly premium.