Improper Obamacare Enrollment Cost US Taxpayers $65,000,000,000 In Just One Year, New Report Reveals

Improper enrollment across Affordable Care Act exchanges cost American taxpayers billions of dollars in 2024, according to a Paragon Health Institute analysis released Wednesday.

Combining Paragon’s previous estimates of improper exchange enrollment and Medicaid expansion enrollment suggests that 14.3 million individuals enrolled in these programs in 2024, or 34% of total ACA enrollees, were actually ineligible, according to the report. The analysis also projects that improper enrollment across the two ACA programs cost the federal government approximately $65 billion in 2024.

Moreover, improper exchange enrollment rose by over 26% from 2024 to 2025, up to an estimated 6.5 million total enrollees, according to Paragon.

“The combined $65 billion cost shows that improper enrollment is not a trivial administrative error,” Paragon’s report states. “It is the predictable result of programs that reward enrollment while weakening incentives to verify eligibility. Until policymakers change those incentives, improper enrollment will persist in both the ACA exchanges and Medicaid expansion.”

A separate Paragon study released in June claimed that almost 27% of all ACA exchange sign-ups were improper in 2026. It also projects taxpayers will pay up to $25 billion in improper subsidies this year, nearly a quarter of total projected ACA subsidy spending for the year.

A KFF analysis published in July found that Obamacare health insurance premiums are likely to rise by double digits again in 2027. Many Republican lawmakers have previously criticized Obamacare, claiming it has caused healthcare costs across the U.S. to soar.

House Speaker Mike Johnson notably referred to the ACA as “the Unaffordable Care Act” in a Dec. 18, 2025 statement posted to X.

“Fifteen years ago, Democrats promised the American people that Obamacare, aka the Unaffordable Care Act, would lower costs, improve care, and let patients keep their doctors,” Johnson said. “It was a LIE. Now we know the truth: that Americans are worse off, and the Unaffordable Care Act has failed.”

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