Trump Officials Eject 750,000 From Obamacare Markets, Claiming Fraud
"Vice President JD Vance said the measure would save the government $2.2 billion.
The Trump administration has ejected more than 750,000 enrollees from the Affordable Care Act insurance marketplaces, Vice President JD Vance announced on Tuesday, claiming that many were receiving premium subsidies they did not qualify for and that some were not real people.
“We’re actually making sure that the people receiving Obamacare subsidies are actually entitled to receive them,” Mr. Vance said at a news conference, using a different name for the health law. He estimated that removing the targeted enrollees would save the government $2.2 billion.
The announcement was the latest initiative by an anti-fraud task force Mr. Vance leads that has often turned its efforts toward federal health programs. In recent months, the task force has been involved in withholding billions in Medicaid funding from Minnesota and California, contending that the states had not adequately combated fraud.
Obamacare enrollment has already declined significantly this year, as the cost of the plans has risen, a potential political risk for Republicans heading into midterm elections in which voters are worried about affordability and the cost of living.
Congressional Democrats immediately criticized the Trump administration’s announcement on Tuesday as an unjustified move to dismantle Affordable Care Act, known as Obamacare.
“Using the false pretext of fighting fraud to strip Americans of their healthcare is as cynical as it is cruel,” Representative Nancy Pelosi, Democrat of California, posted on social media.
The dropped enrollees account for about 4 percent of the 19 million Americans who receive coverage through the marketplaces created by the Affordable Care Act. Many live close to the poverty line.
Under the law, people who earn more than four times the poverty limit — around $64,000 for a single person — are ineligible for subsidies to help them afford premiums. But people who earn less than the federal poverty limit — around $16,000 a year — are also ineligible. The lawmakers who wrote Obamacare had intended that such people would obtain health insurance through an expansion of Medicaid, before the Supreme Court made Medicaid coverage for this low-income group optional for states.
The Trump administration asked health plans to verify eligibility for nearly 1.2 million people who were signed up by a broker and missing a Social Security number or immigration papers, according to a spokesperson for the Centers for Medicare and Medicaid Services, which oversees Obamacare.
Officials then narrowed that list to people who had not filed insurance claims, had no record of contacting the insurer about the coverage and whose premiums were fully covered by government subsidies.
Obamacare enrollees had 30 days to respond to their insurers. Those who were flagged under the criteria and did not respond to their health plan’s outreach had their coverage canceled.
The spokesperson said that if a “legitimate consumer” believed he or she was affected by the cancellations, the person could get coverage reinstated by providing the Obamacare marketplace with their Social Security number.
Mr. Vance said the 750,000 who would lose coverage were a mix of people who did not meet the eligibility requirements or did not exist.
Officials said they planned to investigate an additional 440,000 enrollees who may also fall into one of those categories.
“They had something about their story that was a little bit different than what we expected from the 100 percent fraud story,” Dr. Mehmet Oz, the administrator of the Centers for Medicare and Medicaid Services, said of the Obamacare enrollees the administration would allow to remain enrolled. “We’re giving them another chance.”
In statements, two large insurance industry groups, America’s Health Insurance Plans and the Blue Cross Blue Shield Association, said they welcomed efforts to reduce fraud in the marketplaces.
There is evidence that ineligible low-income people have enrolled in coverage in recent years, either because they overestimated their expected income or because a broker coached them to do so to obtain coverage. The Congressional Budget Office estimatesthat there were around 2.3 million such people in 2025.
There is also evidence that some insurance brokers, who earn commissions for each enrollment, illegally signed people up for coverage without their knowledge, though the number of such people is estimated to be substantially lower. During the Biden administration, health officials decertified around 200 brokers after learning they were engaged in such behavior — in many cases switching people from the plan they chose to another plan to harvest commissions. The Trump administration recertified those brokers last year, but has since removed more brokers from the program.
“We absolutely found that there was a fair amount of unauthorized activity,” said Ellen Montz, who oversaw the Obamacare marketplaces for the Biden administration. She described an uptick in fraudulent enrollments that started in 2024, and said that in response, the Biden administration cracked down on brokers and began requiring more documents during online enrollment.
At the news conference, Dr. Oz focused on fraudulent broker rings and announced a six-month moratorium on new brokers selling Obamacare policies. He highlighted the case of two Florida brokers who had been found guilty of bribing homeless people to enroll in Obamacare plans, so they could earn commissions. Both were sentenced in February to 20 years of jail time.
Cynthia Cox, the director of a program on the Affordable Care Act at KFF, a health research group, said that the administration’s action appeared to fall outside the normal process for verifying eligibility. “There is widespread agreement that unauthorized enrollments should be canceled,” she said. “The question is whether these were all indeed unauthorized enrollments and whether this was the appropriate process for determining whether an enrollee was legitimate or not.”
Ms. Cox and Ms. Montz both noted that problems with the data of enrollees did not necessarily constitute fraud.
“I would absolutely foresee that totally legitimate enrollments are going to get cut off here,” Ms. Montz said.
Enrollment in coverage sold in the Affordable Care Act marketplaces had already fallenby several million this year, after Congress allowed after Congress declined to extend temporary funding that had made coverage less expensive. Prices rose substantially, and many low-income Americans lost access to free coverage. Early filings from insurers suggest that prices will increase substantially again next year. The sign-up period will begin days before the midterm congressional election.
Though there is little current data on the uninsured rate now, estimates from the C.B.O. and other analysts suggest that most of the lower-income people who have lost Obamacare coverage will remain uninsured.
The Paragon Health Institute, a right-leaning research group with close ties to the administration, has published reports estimating that more than a quarter of Obamacare enrollees were improperly signed up. The research noted disproportionate sign-ups among low-income enrollees, enrollments with missing data, and a subset of enrollees who never made medical claims. That research helped inform changes in how people sign up for coverage that were passed into law last year as part of the large Republican tax bill. But those changes do not kick in until after the election.
The administration also tried to add new requirements to the enrollment process through regulation, but the changes have been stopped by a court.
Sarah Kliff is an investigative health care reporter for The Times."
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