The Trump administration has removed more than 750,000 people from Affordable Care Act (ACA) insurance plans, saying they were improperly enrolled or received subsidies they did not qualify for. The decision is part of a broader federal effort led by Vice President JD Vance’s anti-fraud task force to review enrollment practices in government health programs.
The announcement comes as ACA marketplace enrollment has already declined after the expiration of enhanced pandemic-era tax credits that lowered costs for many people. The latest action has renewed debate over how much of the enrollment growth in recent years was linked to fraud and how much reflected expanded access to coverage.
Administration Cites Suspected Improper Enrollments and Broker Activity
Vice President JD Vance and Centers for Medicare & Medicaid Services Administrator Mehmet Oz said the cancellations would save taxpayers about $2.2 billion. According to NBC News, the administration said the affected group included people who may have been enrolled without their knowledge, people who did not meet eligibility requirements, and individuals it described as “phantom” enrollees.
Officials said they identified several factors they considered suspicious, including cases where a broker helped enroll someone, no medical claims were filed, the full monthly premium was covered by federal tax credits, and required identity or eligibility information could not be verified in real time.
The administration also announced additional reviews. According to Reuters, between 419,000 and 450,000 more enrollees are being examined to determine whether they meet eligibility requirements. CMS said it would also block 569 brokers accused of submitting applications with patterns the agency described as statistically implausible.
Health insurance brokers have become a central focus of the investigation. According to The New York Times, officials highlighted cases where brokers allegedly enrolled people without their consent or changed plans to receive commissions. The administration also announced a temporary freeze on new broker registrations for ACA plans.
Experts Debate the Scale of Fraud and the Impact on Enrollment
Health policy researchers agree that improper ACA enrollments have occurred, though they differ from administration officials on the extent of the issue. According to NBC News, the Congressional Budget Office estimated that about 2.3 million people in 2025 were improperly receiving enhanced tax credits.
Experts have questioned whether all of the removed enrollees were fraudulent. Cynthia Cox, director of the ACA program at KFF, told NBC News that some people may have been enrolled without their knowledge, while others may have been legitimately covered but failed to respond to verification requests.
The ACA marketplace experienced significant growth during the Biden administration, rising from about 11 million enrollees to a record 24 million after expanded subsidies increased eligibility for financial assistance. Enrollment later declined as those subsidies expired and premiums became more expensive for many consumers.
According to The Washington Post, Republicans have argued that the enrollment decline reflects efforts to remove waste and fraud, while Democrats and some health policy experts have pointed to rising costs as a major reason people are leaving the program.
The administration’s action affects a portion of the roughly 19 million people enrolled in ACA marketplace plans. Officials continue to review additional cases while health policy groups examine how the changes will affect people who rely on the program for coverage.
