CMS cancels 315,000 Obamacare enrollments covering 760,000 people, citing fraud
The Trump administration says the cancellations will save about $2.2 billion in subsidies, but it has not said how many enrollees were actually ineligible.
What we know
- The Centers for Medicare and Medicaid Services said it canceled about 315,000 Affordable Care Act marketplace enrollments, covering roughly 760,000 people, last month. [1]
- CMS is also verifying about 419,000 people to confirm they are legal U.S. residents and meet income requirements for ACA benefits. [1]
- Vice President JD Vance's White House Task Force to Eliminate Fraud led the action and estimates it will save about $2.2 billion in taxpayer-funded subsidies. [1]
- About 19.2 million Americans are currently enrolled in Obamacare plans, according to a June report from the Office of the Assistant Secretary for Planning and Evaluation. [1]
- Not yet confirmed: It is unclear how many of the 315,000 canceled enrollments involved people who were ineligible for coverage, or whether the earlier administration had failed to verify their eligibility. Oz's claim that about 35% of current enrollees have never used the program was made at the briefing and was not independently substantiated.
The Centers for Medicare and Medicaid Services (CMS) said Tuesday it canceled about 315,000 Affordable Care Act marketplace enrollments last month. The enrollments covered roughly 760,000 people, according to CNBC. [1]
CMS described the enrollments as unauthorized. Vice President JD Vance called the situation "rampant fraud." The action was led by his White House Task Force to Eliminate Fraud, which estimates it will save about $2.2 billion in taxpayer-funded subsidies. [1]
CMS is also verifying about 419,000 people to check that they are legal U.S. residents and meet the income requirements for ACA benefits, according to a CMS release. [1]
At a Tuesday briefing, Vance blamed the Biden administration for maintaining a system that enabled fraud. "You have a system where, on the one hand, brokers are paid money to feed patients into the system, while on the other hand, the government isn't even checking whether the people enrolled are actually eligible for the program. What do you have? Of course, rampant, rampant fraud," Vance said. [1]
It is unclear how many of the canceled enrollments involved ineligible people, or whether the Biden administration had not verified their eligibility. [1]
CMS Administrator Dr. Mehmet Oz said about 35% of people currently in the Obamacare system "have never used the program." He said they never used a prescription or saw a doctor. Oz also pointed to enrollment growth from about 10 million people before the pandemic to roughly 22 million afterward, and said weakened safeguards and a lack of enforcement contributed to improper enrollments. [1]
A June report from the Office of the Assistant Secretary for Planning and Evaluation said "nearly half ... was suspected to be improper, phantom, or fraudulent" of the enrollment growth from 2021 to 2024. The report defined improper or fraudulent enrollment as people misstating their income to get access to free plans. [1]
Enhanced subsidies passed in 2021 under the American Rescue Plan expired at the end of 2025, raising premiums for many people on ACA exchanges. [1]