The Trump administration is moving to remove more than 760,000 people from Affordable Care Act (ACA) coverage, citing suspected enrollment fraud, in a crackdown that could save the federal government $2.2 billion in improperly paid subsidies.
Vice President JD Vance announced the action on Tuesday alongside Mehmet Oz, administrator of the Centers for Medicare and Medicaid Services (CMS). The initiative is aimed at identifying questionable enrollments, preventing unauthorized sign-ups and tightening oversight of health insurance brokers.
The announcement comes as healthcare affordability remains a major concern for Americans, with rising insurance premiums and changes to federal subsidies putting additional pressure on household budgets.
760,000 Enrollees Face Removal Over Suspected Fraud
Vance said the White House task force would remove more than 760,000 enrollees from ACA coverage as part of its effort to address widespread fraud in the health insurance system.
Oz said some of the affected individuals were so-called phantom enrollees who may not exist. Others may have been signed up for health insurance without their knowledge.
The administration estimates that the action will prevent $2.2 billion in improper federal subsidy payments, although the announcement does not establish that every person targeted was involved in fraud.
A further 419,000 enrollees will face additional verification checks. These reviews will examine whether individuals meet the income requirements for subsidies and qualify as legal residents.
Broker Suspensions and Six-Month Hiring Freeze
The administration is also targeting insurance brokers and agents suspected of improperly enrolling people in ACA plans.
Oz said brokers and agents involved in questionable sign-ups would face suspensions. The government will also impose a six-month moratorium on new broker and agent registrations.
The move follows similar action under the Biden administration, which suspended 850 brokers and agents suspected of fraud in 2024. Several hundred were later reinstated by the Trump administration.
Enrollment fraud became a growing concern after enhanced ACA subsidies were introduced in 2021, making coverage more affordable and expanding eligibility for financial assistance.
Some brokers allegedly exploited the expanded subsidies by enrolling people or switching them to different insurance plans without their consent. In some cases, individuals were unaware that their coverage had been changed.
Why the Administration Is Focusing on Phantom Enrollees
The White House crackdown follows concerns raised by Brian Blase, a former healthcare adviser to Trump during his first administration and president of the Paragon Health Institute.
The think tank has highlighted that nearly 12 million ACA policyholders had no medical claims in 2024, describing them as potential phantom enrollees.
Oz also pointed to the number of people who did not use their coverage, saying 35% of enrollees had never used the program. He described this as roughly twice the traditional rate among insured individuals.
However, a lack of medical claims does not, by itself, establish that an enrollee is fictitious or fraudulently enrolled.
Oz further said that 1.1 million enrollees did not have Social Security numbers on file. Going forward, all applicants will be required to provide their Social Security numbers, while CMS plans to introduce additional safeguards for brokers and agents enrolling consumers.
ACA Enrollment Falls as Enhanced Subsidies Expire
The enforcement drive comes at a time of uncertainty for the Affordable Care Act marketplace.
According to the latest Department of Health and Human Services data cited in the announcement, 19.2 million people were enrolled in ACA coverage as of February, down from 21.8 million during the same period a year earlier.
Enrollment had nearly doubled after enhanced premium subsidies were introduced. The additional assistance allowed some lower-income Americans to obtain plans with no monthly premiums and made financial assistance available to more higher-income households.
Those enhanced subsidies have now expired. Financial assistance is once again limited to people earning less than 400% of the federal poverty level, equivalent to $62,600 for an individual and $128,600 for a family of four.
The expiration is expected to add to coverage affordability challenges, particularly as healthcare premiums for ACA plans, employer-sponsored insurance and Medicare have risen for 2026 and are expected to increase again next year.
Healthcare Fraud Becomes a Political Flashpoint
The latest ACA enforcement action also comes as Republicans seek to demonstrate stronger oversight of healthcare spending ahead of the November midterm elections.
Republican officials argue that tackling fraudulent enrollment will protect taxpayers, strengthen federal health insurance programs and help ensure that coverage reaches people who genuinely need it.
Democrats, meanwhile, have been highlighting the potential impact of Medicaid cuts under Trump’s major domestic policy legislation and the expiration of enhanced ACA subsidies. Both changes are expected to contribute to millions of people losing health coverage in the coming years.
The Affordable Care Act has long been a target of Trump, who previously sought to repeal the law and later pursued efforts to weaken it.
Brad Woodhouse, president of the advocacy group Protect Our Care, criticised the latest initiative, calling it a political stunt intended to remove more people from health coverage while being presented as a taxpayer savings measure.
With hundreds of thousands of ACA enrollees facing removal and hundreds of thousands more subject to additional checks, the administration’s challenge will be to distinguish fraudulent enrollments from legitimate policyholders who may have been caught up in questionable broker activity.
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