From NBC News · Berkeley Lovelace Jr. · · 1m 50s
Trump cuts ACA coverage for 750,000 over fraud claims
The administration removes hundreds of thousands from health insurance, claiming widespread fraud, but experts question how much fraud actually exists.
In brief
The administration removes hundreds of thousands from health insurance, claiming widespread fraud, but experts question how much fraud actually exists. While some ACA fraud occurs, experts say the administration may be overstating its scale and ignoring that most enrollment losses stem from unaffordable premiums after…
750,000 lose ACA coverage
The Trump administration removed roughly 750,000 people from Affordable Care Act plans, claiming they received subsidies they didn't qualify for or didn't actually exist.
“These programs are deserving, they are important, but they're not going to exist unless we stop the fraud.”
Vance and Oz lead fraud crackdown
Vice President JD Vance and CMS Administrator Mehmet Oz announced the removals, saying they would save taxpayers 2.2 billion dollars and represent part of a broader effort to eliminate fraud in government health programs.
ACA enrollment surged during pandemic
ACA enrollment jumped from 11 million to 24 million during the Biden administration when enhanced tax credits expanded eligibility. Enrollment dropped by 3 million this year after those credits expired, making premiums unaffordable.
Oz claims brokers drove fraud
CMS Administrator Oz said insurance brokers enrolled people without their knowledge to collect commissions, and that some enrollees had incomes making them ineligible for subsidies, duplicate plans, or didn't exist at all.
“In fact, the fact that we have 23 million makes me think we have too many participants in the ACA.”
Administration targets 'phantom' enrollees
The administration identified suspicious enrollees through multiple factors: broker enrollment, no claims filed, full premium coverage by tax credits, and unverifiable Social Security numbers or immigration documents. Oz called them phantoms.
“We call them phantoms, because we believe most of them don't exist or they had no idea they had coverage.”
Experts question fraud scale
Health policy experts acknowledge ACA fraud exists but question whether the administration is overstating it. The Congressional Budget Office estimated 2.3 million improper enrollees in 2025, but experts say most enrollment losses stem from unaffordable premiums, not fraud.
“It is entirely possible that many of these people were legitimately enrolled and simply did not respond in time.”
419,000 more under investigation
The administration is investigating an additional 419,000 people it says may be improperly enrolled, giving them another chance to prove their eligibility before potential removal.
The big picture
While some ACA fraud occurs, experts say the administration may be overstating its scale and ignoring that most enrollment losses stem from unaffordable premiums after subsidies ended.
