House Republicans subpoena health insurers for Obamacare fraud investigation

House Judiciary Committee Republicans issued subpoenas to eight Affordable Care Act health insurers — a recent development in a wider investigation of fraud in Obamacare subsidy use.

House Judiciary Chair Jim Jordan sent the formal inquiries Monday in an attempt to obtain more information on the health insurers’ subsidized ACA enrollees and each company’s fraud-protection measures.

The subpoenas were sent to Blue Shield of California, Centene Corporation, CVS Health, Elevance Health, GuideWell, Health Care Service Corporation, Kaiser Permanente and Oscar Health.

Enhanced premium tax credits for ACA coverage expired at the beginning of the new year, but as Medicare and Medicaid fraud have dominated the national conversation, Republicans are doubling down on their probe.

The lawmakers cite a December Government Accountability Office report that found billions of dollars in unsettled Obamacare subsidies per year and examples of tens of thousands of Social Security Numbers subject to potential fraud.  

The letters are follow-ups — the insurers were asked for documents and information in December after federal auditors exposed fraud risks — as their individual responses did not answer all of the committee’s questions, according to the letters.

Mr. Jordan, along with two of his subcommittee chairmen — Republican Reps. Scott Fitzgerald of Wisconsin and Jeff Van Drew of New Jersey — laid out multiple requests.

Mr. Fitzgerald is chairman of the Judiciary subcommittee on the Administrative State, Regulatory Reform and Antitrust while Mr. Van Drew leads the oversight subcommittee.

They asked each insurer for documentation of the number of enrollees receiving ACA subsidies and how much money was received from the subsidies between 2020 and 2025.

They also requested information on enrollees with subsidies who did not utilize any benefits in a given year, how many employees work on subsidy-related fraud, communications with federal regulators on waste, fraud and abuse and internal and external audits related to subsidy fraud.

The documents requested will help determine whether legislative changes are needed to address ACA fraud.

The insurers were given a Feb. 23 deadline to send the requested information to the committee.