The House Judiciary Committee issued subpoenas Feb. 9 to eight health insurers, seeking documents about potential fraud issues related to ACA marketplace subsidies.
The subpoenas target Blue Shield of California, Centene, CVS Health, Elevance Health, GuideWell, Health Care Service Corp., Kaiser Permanente and Oscar Health. All eight had failed to fully comply with a voluntary document request the committee sent in December, according to a Feb. 10 news release from the committee.
Committee Chairman Jim Jordan (R-Ohio), along with Reps. Scott Fitzgerald (R-Wis.) and Jeff Van Drew (R-N.J.), are demanding information about each company’s fraud-protection measures, with the insurers having until Feb. 23 to produce the requested documents.
The subpoenas come after a December Government Accountability Office report found billions of dollars in unreconciled ACA subsidies per year and flagged tens of thousands of Social Security numbers subject to potential fraud. The committee said it is investigating whether the Administrative Procedure Act needs to be reformed so that fraud-prevention measures can be implemented more quickly.
ACA premium tax credits are paid directly from the federal government to insurers, covering an enrollee’s premium costs above a percentage of their income. The letters note that the payment structure means insurers collect more money from the government when they raise premiums, but consumers don’t see the cost increase when choosing a plan.
The probe adds another layer to the political fight over enhanced ACA subsidies, where negotiations to extend the expired credits fell apart in February. Some Democrats involved in the negotiations said the talks stalled over disagreements on how to handle abortion coverage.
Separately, the Trump administration issued the Marketplace Integrity and Affordability Rule in June 2025 to tighten ACA fraud protections and enact stricter eligibility verifications, but a federal judge paused the rule in August, finding CMS had violated the APA. That decision is on appeal.
On Feb. 9, CMS unveiled a proposed rule that would tighten eligibility verifications, and re-introduce several program integrity measures that were blocked by the federal court.
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