Enrollment in Obamacare’s exchange is falling, according to a new analysis from the Commonwealth Fund. The study suggests that the expiration of the enhanced premium subsidies enacted during the pandemic has made coverage unaffordable for many Americans. Some consumers undoubtedly have decided that exchange plans are no longer worth the cost.But that explanation overlooks a different possibility. A substantial share of Obamacare’s recent enrollment growth may never have reflected legitimate coverage in the first place.
According to a report from the Paragon Health Institute, roughly 12 million marketplace enrollees generated no insurance claims in 2024. It strains credulity to believe that all of those individuals simply remained healthy throughout the year. A more plausible explanation is that many were enrolled without their knowledge by brokers seeking commissions tied to sign-ups.Federal regulators have acknowledged that this is a real problem. In 2024, the Centers for Medicare and Medicaid Services received hundreds of thousands of complaints involving unauthorized enrollments and plan switches. CMS subsequently suspended hundreds of brokers pending investigations into alleged misconduct.An Obamacare sign is displayed outside an insurance agency on Nov. 12, 2025, in Miami. (Photo by Joe Raedle/Getty Images)
