The Trump administration has removed nearly 5 million people from Affordable Care Act (ACA) insurance rolls, citing fraud investigations. The move follows a surge in enrollments during the Biden administration, which the Trump administration alleges was driven by improper sign-ups. Meanwhile, health policy experts point to rising premiums as a key factor in the enrollment decline.
Part 1: Immediate Action & Core Facts
- 5 million people have been disenrolled or failed to pay premiums for ACA coverage in 2026, according to new data.
- The Trump administration claims it has uncovered $10 billion in fraudulent claims between 2021 and 2024, leading to the removal of nearly 3 million enrollees and plans to remove an additional 2.6 million.
Part 2: Deeper Dive & Context
Fraud Investigations and Enrollment Surge
The Trump administration attributes the enrollment drop to fraud, alleging that relaxed eligibility checks under Biden led to phantom enrollments and misstated income levels. A report obtained by Fox News Digital estimates that 5.6 million improper enrollments peaked in 2025, with 2.6 million remaining.
Rising Premiums and Policy Changes
Health policy experts, including Cynthia Cox of KFF, argue that the 13% drop in enrollment is largely due to skyrocketing premiums after the expiration of enhanced tax credits. The Trump administration has since restored income verification, ended some special enrollment periods, and investigated duplicate Medicaid enrollments.
Political and Policy Implications
The Trump administration’s actions have sparked debate over the ACA’s integrity. While some argue the crackdown is necessary to curb fraud, others contend it disproportionately affects low-income enrollees. The Biden administration’s policies, which expanded eligibility and subsidies, are now under scrutiny as the Trump administration reverses some of those measures.