Imagine waking up to find you’ve been signed up for health insurance you never wanted, all while taxpayers foot the bill.

Paragon Health Institute, a healthcare policy group, has reported that as many as 6.4 million Americans may have been unknowingly enrolled in Affordable Care Act (ACA) plans, often through brokers offering incentives like gift cards.

The group estimates that by 2025, this number reflects millions more than are actually eligible for these zero-premium plans, which are fully funded by taxpayer subsidies. Brian Blase, president of Paragon Health Institute, has highlighted systemic issues in federal-state funding structures, pointing to potential fraud and waste in states like Minnesota, New York, and California.

Uncovering Unwitting Enrollment in Obamacare

Critics argue that the expansion of ACA subsidies in 2021-2022, passed through budget reconciliation, opened the door to exploitation, according to Just the News. These subsidies made coverage free for certain income brackets, but they also created a loophole for brokers to enroll people—sometimes without consent—using personal data obtained through deceptive tactics.

According to Paragon’s findings, many of these enrollees had no idea they were covered since the government paid premiums directly to insurers. Insurers, in turn, handed out hefty commissions to enrolling agents, raising questions about accountability.

Blase has been vocal about how this system fails the public, particularly when 40% of those in fully subsidized plans used no healthcare services at all in 2024. That figure is 2.5 times higher than typical rates, meaning taxpayers shelled out for coverage that often went unused.

Taxpayer Burden and Systemic Flaws

Blase puts it bluntly: "The government was sending massive checks to insurance companies who were making windfall profits on behalf of people who didn't use any health care." This isn’t just a glitch; it’s a design flaw where insurers rake in cash without delivering value.

Look at the incentives—insurance companies now rely on taxpayer money for 85% of their revenue, as Blase notes. With the U.S. Treasury as their main client, there’s little push to keep costs down or prioritize patient needs.

Then there’s the state-level mess, like in Minnesota, where historic levels of fraud and waste in programs tied to federal-state partnerships burden not just locals but the entire nation. Blase argues that when states spend a dollar, they draw nine more from federal coffers, diluting accountability.

Fraud Across States Raises Alarms

Blase warns of patterns beyond Minnesota, pointing to New York’s spike in Medicaid-funded home health aides, often family members, as a potential hotbed for misuse. California’s hospice care industry also faces scrutiny for fraudulent claims. These aren’t isolated issues but symptoms of a broader problem with oversight.

Federal funding, Blase contends, fuels this waste with an open checkbook mentality. He’s been tackling entitlement fraud for nearly a decade and insists the burden on taxpayers is unsustainable.

His proposed fix? "It's the essential step. The federal government is bankrolling the fraud, waste, and abuse in the states, and as long as states can draw on an open checkbook from Washington, they don't have incentives to make sure that dollars are appropriately spent."

Call for Oversight and Reform

Blase also slams the lack of federal vigilance, noting the government has data on explosive spending but fails to act. Cases like Minnesota’s daycare fraud, where empty facilities still got paid, shouldn’t require amateur sleuths to expose.

The numbers are staggering—6.4 million potentially ineligible enrollees by 2025, with taxpayers on the hook for plans many don’t even know they have. This isn’t just inefficiency; it’s a betrayal of public trust.

Reining in these programs means cutting off endless federal funding streams, a move Blase champions to force states to clean house. Without reform, the cycle of waste and fraud will grind on, hitting hardworking Americans hardest.