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**NOVEMBER 18, 2025**

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As Senate Democrats made an almost arbitrary decision to shut down the government in a Hail Mary attempt to negotiate an extension to some vital Affordable Care Act subsidies, MAGA firebrand Marjorie Taylor Greene publicly admitted something Republicans had never been allowed to say before: For all its faults, Obamacare is better than nothing. A deep dive into the murky, high-deductible “bronze tier” of the ACA marketplace and the scammy call centers and “street marketers” that sell them reveals the corollary of Greene’s admission: “better than nothing” is still pretty bad. What follows is a true crime story [link removed] on why we need a public option.

**–Maureen Tkacik, investigations editor **

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The Obamacare Boiler Room [link removed]

Just four miles north of Mar-a-Lago, two men in their mid-forties are currently on trial [link removed] for conspiracy to defraud Obamacare of $161 million via a family insurance brokerage called the Fiorella Insurance Agency. Their alleged scheme was a variation on a rich Florida tradition that dates back at least to the late 1960s: use fancy luncheons and freebies to induce poor and desperate people to sign up for government-subsidized insurance plans, count on poverty and desperation to keep them from complaining too loudly when and if their claims get denied, buy yacht(s).

Since the first experiments in Medicare and Medicaid privatization in the early 1970s, entrepreneurs from Miami to Naples to Port Saint Richey have used everything from supermarket gift cards to opioids to lure the poor and unsuspecting onto the rolls of unscrupulous health maintenance or “accountable care” organizations and their affiliated insurance companies. The Fiorella agency’s innovation was that it specialized in selling Obamacare, the individual insurance plans designed for self-employed professionals, very small businesses, and others who’d had trouble obtaining health insurance before the new shopping “marketplaces.”

As the Affordable Care Act’s legacy has been tarnished by the protracted orgy of corporate consolidation and financialization [link removed] that followed its passage—to say nothing of surging costs and plunging life expectancies—the fact that hemophiliacs and parents of children with muscular dystrophy maintain the right to buy health insurance instead of living in constant fear of bankrupting their employers or getting kicked off the rolls remains a relatively unalloyed achievement of an otherwise terrible law/presidency. Or at least, I thought it did.

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