The Majority Report with Sam Seder 3534 - The Obamacare Boiler Room; Zohran's Deputy Mayor w/ Maureen Tkacik, Dean Fuleihan
Nov 28, 2025
Maureen Tkacik, an investigative writer focused on healthcare policy, shares insights on the challenges posed by the Affordable Care Act, revealing the alarming rise in insurance premiums and the prevalence of fraudulent enrollment practices in Florida. Dean Fuleihan, the Deputy Mayor-elect, discusses the incoming Mamdani administration's priorities, his journey as a Lebanese immigrant, and the importance of community engagement. The conversation emphasizes the intersection of healthcare and local governance, highlighting how policy directly affects residents' lives.
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ACA As A Pseudo-Market That Enables Rent-Seeking
- The ACA created a pseudo-marketplace that left space for rent-seeking and inefficiency in insurance delivery.
- Maureen Tkacik argues those structural market incentives enabled massive private profiteering rather than efficient public coverage.
ARPA Subsidies Created New Enrollment Incentives
- The 2021 subsidy changes capped premiums at 8.5% of income and dramatically changed enrollment incentives.
- That cap made zero-premium plans easy to sell and shifted the risk pool and costs across income brackets.
Boiler Rooms Targeting Vulnerable People
- Fiorella Insurance Agency ran 'boiler room' operations targeting bus stops, shelters and motels to sign people up.
- They bribed enrollees and falsified paperwork to move Medicaid-eligible people onto subsidized ACA plans for commissions.