Wanna see where my critical thinking essays and current political news collide showing real world consequences?Awesome! Lets go!On Wednesday, the Government Accountability Office released a report showing that 23 of 24 fictitious applications submitted by auditors were approved for subsidized Affordable Care Act coverage. Eighteen fake enrollees were still collecting over $10,000 monthly in taxpayer-funded subsidies as of September. The report also found 58,000 Social Security numbers matching death records that received $94 million in subsidies during 2023, and $21 billion in premium tax credits that couldn’t be verified with tax returns.
Republican lawmakers who requested the investigation called it a smoking gun. Theyre using it to argue against extending enhanced ACA subsidies set to expire December 31.
Heres the thing about smoking gunsThe GAO ran this exact same test in 2014, 2015, and 2016. Every fake applicant got approved back then too. The report explicitly notes that 2024-2025 results are generally consistent with results of similar testing conducted nearly a decade earlier. This vulnerability has been documented, flagged, and ignored for ten years. Republicans held Congress and the White House from 2017 to 2019. They passed no reforms.
Then there’s this year. CMS suspended 850 brokers in 2024 for suspected fraud. The Biden administration finalized new anti-fraud rules in January 2025. By May, after the Trump administration took over, those suspended brokers were reinstated.
WHAT? Yep.
So the party screaming about fraud just put the fraudsters back to work. And now they’re waving this report around as evidence that 22 million Americans should lose their health insurance subsidies.
This is anecdotal thinking at its finest.
I wrote an essay this week about why personal experience is the lowest form of evidence. Not because people lie, but because memory gets contaminated by every cognitive bias in the book. When someone says I know a guy who abuses SNAP benefits, they’re extrapolating from one data point to condemn a program that feeds 41 million people. Theyre letting emotional reaction override objective analysis.
Republicans are doing the same thing here, just with a government report instead of a neighbors cousin.
The GAO found fraud. Thats real. But using fraud to argue against the program requires ignoring every question that matters. What percentage of enrollees are legitimate versus fraudulent? What happens to the uninsured rate when subsidies exist versus when they’re cut? What does shrinkage look like in ACA compared to other government programs? What are the actual health outcomes for the 22 million people who depend on these subsidies?When you look at the data, you find that letting the enhanced subsidies expire would cause premiums to more than double on average. About 4 million people would lose coverage entirely. The Congressional Budget Office has run the numbers. KFF has run the numbers. The math isn’t ambiguous.
The fraud exists. But every large system has shrinkage. Every program has people who abuse it. Thats not an argument against the program. Thats an argument for comparing overall outcomes to costs and making a rational decision about whether the benefits outweigh the problems.
Its also an argument to just fix the actual issues rather than throwing the baby out with the goddamn bath water.
Republicans arent making that calculation. Theyre pointing at dead people getting benefits and saying therefore we should let millions of living people lose coverage. Thats not policy analysis. Thats emotional manipulation dressed up as fiscal responsibility.
And they’re counting on you not to notice that they ignored this problem for a decade, that they reinstated the brokers who got suspended for fraud, and that their proposed solution punishes legitimate enrollees while doing nothing to fix the verification systems that allowed the fraud in the first place.
If fraud were the actual concern, youd tighten verification. Enforce existing rules. Keep the suspended brokers suspended. Fund the oversight mechanisms. You don’t torch a program that provides healthcare to 22 million people because auditors proved what everyone already knew: that verification systems need improvement.
The GAO report is real. The fraud is real. But treating it as grounds to end enhanced subsidies requires the same lazy thinking that leads people to oppose SNAP because they heard about someone buying lobster. Its letting a handful of bad actors override mountains of evidence about what the program actually accomplishes.
Thats not critical thinking. Thats System 1 running the show while System 2 takes a nap.