One of Paragon’s core missions is to evaluate how government programs actually work and whether benefits are reaching the people they were designed to help, whether programs are improving lives, and whether taxpayer costs are justified. Our research and analysis show that program outcomes often differ substantially from policymakers’ stated objectives and that incentives frequently benefit organized interests at the expense of enrollees and taxpayers.
For the third straight year, we produced a study of improper enrollment in the exchanges. In The Persistent Obamacare Enrollment Fraud, we estimate that there were 6.2 million improper enrollees after the 2026 open enrollment period. On Friday, after analyzing our findings, the Washington Post editorial page wrote: “The scale of the fraud might seem implausible, but the evidence supporting it is compelling.” On June 23 at 1 p.m. EDT, we…
MANAGEMENT & CULTURE (THE “TONE AT THE TOP”)
Fraud thrives in “sloppy” environments where leadership ignores the rules.
- The Fraud Triangle: For fraud to occur, three elements must be present: Pressure (the need for money), Rationalization (thinking “I deserve this”), and Opportunity (weak controls). You can only control the Opportunity.
- Whistleblower Hotline: Provide an anonymous way for staff to report “odd behavior.” Most internal frauds are caught via tips, not audits.
- Background Checks: Conduct credit and criminal record checks for all employees in financial or data-sensitive roles.
- Annual Ethics Training: Make sure every staff member knows that the company has a Zero Tolerance policy toward “borrowing” from petty cash or fudging overtime.