WASHINGTON — The Trump administration announced Tuesday it will remove 760,000 people from Affordable Care Act (ACA) health insurance plans, alleging they were fraudulently enrolled or do not exist. The action is part of a broader crackdown on fraud in government health programs, with officials projecting $2.2 billion in savings from canceled subsidies.
Vice President JD Vance, who leads the White House Fraud Task Force, and Dr. Mehmet Oz, administrator of the Centers for Medicare and Medicaid Services (CMS), outlined the measures at a White House press conference. Vance stated the administration had identified unauthorized enrollments and eligibility violations, including cases where individuals were enrolled without their knowledge by insurance brokers seeking commissions.
Key actions announced:
- Removal of 760,000 enrollees from ACA plans due to suspected fraud or ineligibility.
- Additional verification for 419,000 enrollees to confirm citizenship and income eligibility.
- A six-month moratorium on new broker applications to prevent further fraudulent enrollments.
Vance criticized the Biden administration’s policies, stating that relaxed eligibility checks and incentives for brokers to enroll individuals created "a perfect recipe for rampant fraud." He cited examples of fraud rings involving brokers who enrolled tens of thousands of ineligible or non-existent individuals to collect federal subsidies.
How the removals were determined
Officials did not provide a full breakdown of how individuals were selected for removal but described a mix of "phantom enrollees" and people who failed to meet eligibility requirements. Some enrollees were allegedly signed up without their consent by brokers, while others may have been incorrectly flagged due to administrative errors. The administration has not released specific data on how many of the removed individuals were legitimate enrollees who lost coverage.
Reactions and concerns
Health policy experts and advocacy groups have raised questions about the scale and accuracy of the removals. Cynthia Cox, senior vice president at KFF, noted that while some enrollees may have been fraudulently added, others could have been legitimate participants who did not respond to verification requests in time. "There is no way to know how many legitimately enrolled people had their plans canceled," Cox said.
The ACA enrollment has fluctuated in recent years. During the Biden administration, enrollment rose from 11 million to 24 million due to expanded subsidies during the pandemic. However, enrollment dropped by 3 million this year after enhanced subsidies expired, increasing premium costs for many participants.
Broader implications
The administration framed the crackdown as a necessary step to protect taxpayer funds and ensure subsidies go only to eligible individuals. Critics, however, argue the removals could destabilize health coverage for thousands of Americans, particularly those who may have been incorrectly flagged. The policy also raises questions about the long-term sustainability of the ACA’s enrollment verification processes.
The CMS fact sheet accompanying the announcement did not detail how affected individuals were notified or provided avenues for appeal. The administration has not indicated whether additional removals are planned in the future.