MASSIVE fraud bombshell rocks Washington after $200 billion lost

Republicans have made it very clear that we would like to work with Democrats to address the affordability of health care and find solutions that actually reduce costs. But as Democrats have made clear with this, quote, clean bill, they're not really after health care solutions. They seem to be OK with a 90% fraud rate. They're after a political issue to attempt to batter Republicans with during this next

election year.

That's Senate Majority Leader John Thune criticizing the Democrats' health care plan, accusing the party of prioritizing politics over real reform, as Obamacare subsidies are set to expire by the end of the year. The Senate expected to vote as early as Thursday on the Democrats' proposal, which extends those tax credits for three years.

Some Senate Republicans are backing an extension with income limits and anti-fraud measures. Others favor giving money directly to Americans through health savings accounts. Joining me now is Montana Congressman Troy Downing, a member of the House Financial Services Committee. Congressman, good to see you. Thank you so much for being here.

And I know the House speaker is expected to introduce a House-backed health care plan later this month. What can you tell us?

Well, you know, first of all, I just And the problem with that, if they're allowed to expire, premiums go up. If it's extended, premiums go up. It's already baked into the system. And a lot of people don't understand that these filings happened months ago. The open enrollment period is effectively closed for the 2026 calendar year, and that's already baked into these premiums.

And so if we extend it for six months, no effect. If we extend it for a year, it really has no effect for the 2026 premium year unless we go through the whole process now that everybody's already purchased their insurance on the marketplace.

And just to be clear, this is only for folks that are purchasing their healthcare on the marketplace. This doesn't affect small group, large group, any of the other classes. It's just for that individual market. And these prices are all—it's already baked in for the 2026 calendar year. So if we did, let's say, a two-year extension, we would have to go through the whole process

of allowing the payers, the insurance companies, to refile new rates with these premium tax credits extended. And then we would have to open up a whole other enrollment, open enrollment period. So when's that going to be? January, February, March? I mean, we're already into the premium year.

I mean, the whole thing is a mess. But one thing I will say that Leader Thune was talking about is we need to have a good faith effort on both sides of the aisle. We need to get the Democrats to come and not politicize this because we all agree on one thing. The Democrats and the Republicans all agree that the Affordable Care Act, that Obamacare

has been a complete failure and nothing has done more to raise the costs of healthcare and health insurance than the Affordable Care Act. And it's really easy to understand why. You added, you know, coverages, you know, the essential health benefits, you added coverages to require, the insurance companies were required to cover, and that raised prices.

And as you raise prices, healthy people come off because they don't want to pay that additional price. And that's called adverse selection. It concentrates the risk, so that makes the expenses for the insurance company go up and you get into this spiral of constantly prices going up more people coming off and it's not the not the people that really

need it is the people that are healthy and that's the spiral and so we need to have good faith conversations with our colleagues on the other side of the aisle on what we can do to address costs and that's one a part of the conversation that nobody's talking about.

Well, I mean, President Trump has been talking about it, certainly, and coming up with new ideas to try to get prescription drug prices lower. But where do you think the subsidies conversation goes? Do you think you'll do anything, that Congress will do anything by year end?

Well, I, you know, there's actually, there's two parts of this conversation. There's folks that are worried about doing something with that. But the question that nobody's been able to answer for me is what does that look like if we actually extend those subsidies? Does that mean we have another open enrollment period? Do we completely, you know, upturn the cart and sometime in the middle of a policy year suddenly have everybody who's already bought their

insurance, already made their selections for 2026, have to go back and do it again. So it's not really clear what even the mechanics of that would look like right now with the system that we've inherited.

Congressman, let me switch gears, because your new bill just cleared the House, the SBA Fraud Enforcement Extension Act. It's aiming to crack down on COVID loan fraud. And I guess there was a fair amount of it. Tell us about the bill.

Yeah, well, first of all, we're estimating about $200 billion in fraud. And these are bad actors with the restaurant revitalization program. There's programs that were there to help businesses that were adversely affected

by the forced shutdowns during COVID. And there were a lot of bad actors there. And so the statute of limitations on that was five years that's closing in on us really quickly. And investigators haven't had the time that they need to actually go after these bad actors.

And so what this bill does is it extends the statute of limitations for 10 years. So we get an additional five years so that these bad actors can be investigated and those who cross the line prosecuted. We can start clawing some of that back. And it's really unfortunate we have to do that and that so many people took advantage, you know,

to the tune of $200 billion against a program that was intended to help businesses that were adversely affected by the COVID pandemic. Yeah, we're with Paul Morrow this morning.

Paul, jump in here. This fraud was talked about so much when it was first uncovered, and now we hear what the congressman is telling us, $200 billion.

Your thoughts?

Yeah. Well, my question would be that any federal money that's rolled out that the states get to administer has to come with very strong federal safeguards because from the state level these things are viewed as OPM, other people's money. We're seeing it in Minnesota relative to the billions going overseas funding pirates, funding terror groups.

And I can tell you any law enforcement officer who's worked front line has seen the massive amount of fraud that occurs relative to money coming into the states. And here in New York City, it is another pandemic. And it's very, very frustrating to see because we don't seem to have the mechanisms to counter it. And so all I would say is going forward, in addition to extending the statute of limitations, which is of course direly needed, mechanisms to capture this stuff at the state level, perhaps the states have to be cut out

of it, but I can tell you that at the state level, they view this as money that just came in the transom.

Congressman.

Yeah, well, I'm going to tell you that, yes, I agree. And one of the things that the Republicans have really been pushing, especially this Congress, is going after waste, fraud, and abuse. And this is that fraud part. We need to not only claw that back, make sure that states are being appropriate with anybody coming from the Feds, and that we are tracking that, making sure it's not being wasted and

abused. And we're seeing that not just in the program that we're talking about right now, we're seeing it in other programs, you know, how they administer, you know, their SNAP programs, how they administer their, you know, healthcare program. We need to make sure that we're looking at all of that, that we have the safeguards as a lot of us campaigned on, a lot of us ran on, and a lot of us continue to discuss is we need to pull back that keeps accumulating, a big chunk

of that is fraud, waste and abuse. And we need to be very diligent on not only making sure that we're going after that, but we're putting in appropriate safeguards as not being abused by bad actors, state actors or anyone else.

Real quick on the president's trip, President Trump is headed to Pennsylvania today. He'll talk about how the administration has been making America affordable again. AAA is reporting the national average for gas is down below $3 a gallon, down nearly 20 cents from when the president took office and below $3 for the first time in four years. Congressman, what else do you want to see in terms of affordability?

Well, you know, one of the big things that my constituents are concerned about, and I think Americans are concerned about, is affordability of housing. And that's something that we're taking on now in financial services. And Chairman Flood, under the Housing and Insurance Subcommittee, is working on this and making sure that we're making it so right now the affordability of a house is so high that the median first-time buyer is 40 years old.

And that's pinnacle to the American dream. That, I mean, that's the main part of that. We need to make sure that, you know, folks can get into a home, that young families can. And so affordability on housing is a big thing, obviously at the grocery store. And then the next thing I would say is energy.

We need to make sure that folks can, you know, heat their homes, drive their cars. One of the biggest drivers to prosperity is affordable, reliable energy. And I think that we've got that, you know, clear in our sights.

Absolutely. Congressman, it's good to see you this morning. Thanks so much.

Thank you so much for having me, Maria. Thank you so much for having me, Maria.

Troy Downing on Capitol Hill. We'll be right back.