U.S. Senator John Boozman (R-AR) and Senator John Cornyn (R-TX), along with 13 other Senate Republicans, have requested the Department of Justice (DOJ) to investigate and seek civil remedies for fraudulent Affordable Care Act (ACA) subsidy payments made during the Biden administration. The senators sent a letter to DOJ Civil Division Assistant Attorney General Brett Shumate, expressing concerns about unauthorized or improper enrollments in insurance plans that they say cost American taxpayers.
“President Biden’s expansion of ACA subsidies in 2021 under the American Rescue Plan Act allowed $0 premiums in silver plans on the ACA marketplace, emboldening certain brokers and agents who sought to profit from enrolling as many consumers as possible onto ACA insurance plans, even without consumer consent,” the senators wrote.
“I urge you to evaluate civil remedies to recover ACA subsidy payments made to insurance companies due to waste, fraud, and abuse. Americans deserve to know that their taxpayer dollars are not being spent in furtherance of fraudulent ACA marketplace enrollment schemes,” they continued.
The letter details concerns over broker and agent activity resulting in improper enrollments. According to the senators, brokers receive commissions from insurers for each enrollment while insurers receive direct federal subsidies. They argue this system creates opportunities for fraud at taxpayer expense.
The lawmakers referenced data from the Centers for Medicare & Medicaid Services (CMS), which received about 275,000 complaints between January and August 2024 regarding consumers being enrolled or having their plans changed without consent.
They also cited recent criminal convictions involving fraudulent ACA enrollments. In April 2025, a Florida executive pleaded guilty to submitting false applications that led to at least $133.9 million in improper subsidies paid by the government. In November 2025, two executives were convicted for their roles in a scheme resulting in $180 million in fraudulent subsidy payments.
A Government Accountability Office (GAO) report found persistent risks related to fraud within the ACA marketplace. The GAO reported that all fictitious applicants it submitted were approved for coverage in plan year 2024 and most were approved again for plan year 2025. The report also highlighted issues such as misuse of social security numbers and lack of evidence showing reconciliation for more than $21 billion in subsidies during tax year 2023.
Boozman expressed support for efforts by federal agencies aimed at combating healthcare fraud: “I’m encouraged by the reconstitution of the HHS-DOJ False Claims Act Working Group, which shows this administration’s commitment to combat healthcare fraud and to restore integrity to the federal healthcare system.”
The senators requested information on what mechanisms exist within DOJ for recovering funds tied to fraudulent enrollments and whether actions under laws like the False Claims Act are being considered against insurers involved.
Senator Boozman represents Arkansas in the U.S. Senate where he serves on several committees including Appropriations, Veterans’ Affairs, Environment and Public Works, and Rules and Administration according to his official website. He has also worked on legislation related to veterans’ care and modernizing education benefits through updates like those made with the GI Bill [source].
