The Trump administration has ejected more than 750,000 enrollees from the Affordable Care Act insurance marketplaces, Vice President JD Vance announced on Tuesday, claiming that many were receiving premium subsidies they did not qualify for and that some were not even real people.
“We’re actually making sure that the people receiving Obamacare subsidies are actually entitled to receive them,” Mr. Vance said at a news conference. He estimated that removing the Obamacare enrollees would save the government $2.2 billion.
The announcement is the latest initiative by an anti-fraud task force Mr. Vance leads that has often turned its efforts toward federal health care programs. In recent months, the task force has been involved in withholding billions in Medicaid funding from Minnesota and California, contending that the states have not adequately combated fraud.
Governors have criticized the Trump administration’s antifraud work as politically motivated, often targeting states with Democratic leadership.
The enrollees that the Trump administration plans to remove account for about 4 percent of the 19 million Americans who receive coverage through the marketplaces created by the Affordable Care Act, also known as Obamacare.
Mr. Vance said the 750,000 who would lose coverage were a mix of people who either did not meet the eligibility requirements or did not even exist. The administration plans to do more research on an additional 440,000 people who may also fall into one of those categories.
“They had something about their story that was a little bit different than what we expected from the 100 percent fraud story,” said Dr. Mehmet Oz, the administrator of the Centers for Medicare and Medicaid Services, of the Obamacare enrollees it would allow to remain enrolled. “We’re giving them another chance.”
People who earn more than four times the poverty limit — around $64,000 for a single person — are ineligible for subsidies. But people who earn less than the federal poverty limit — around $16,000 a year — are also ineligible because the lawmakers who wrote Obamacare had intended that such people would obtain health insurance through an expansion of Medicaid, before the Supreme Court made Medicaid coverage for this low-income group optional for states.
There is evidence that some such people have enrolled in coverage, either because they innocently overestimated their expected income or because a broker coached them to do so to obtain coverage. The Congressional Budget Office estimates there were around 2.3 million such people in 2025.
There is also evidence that some brokers illegally signed people up for coverage without their knowledge, though the number of such people is estimated to be substantially lower. During the Biden administration, health officials decertified around 200 brokers after learning they were engaged in such behavior. The Trump administration recertified those brokers last year.
Researchers from the Government Accountability Office who deliberately tried to mislead marketplace officials were able to complete fraudulent enrollments. But those analysts used aggressive techniques, such as submitting forged documents. At the news conference, officials did not allege that individual enrollees were pursuing such strategies.
At the news conference, Dr. Oz focused on fraudulent broker rings and announced a six-month moratorium on new brokers selling Obamacare policies. He highlighted the case of two Florida brokers who bribed homeless individuals to enroll in Obamacare plans, so they could earn commissions. Both were sentenced to 20 years of jail time in February.
Enrollment in coverage sold in the Affordable Care Act marketplaces had already fallen by several million this year, after Congress allowed extra subsidies that helped people buy coverage to expire. Prices rose substantially, and many low-income Americans lost access to free coverage. Early filings from insurers suggest that prices will increase substantially again next year. The sign-up period will begin days before the midterm congressional election.
Though there is little current data on the uninsured rate now, estimates from the Congressional Budget Office and other analysts suggest that most of the lower-income people who have lost Obamacare coverage will become uninsured.
Trump administration officials have alleged widespread fraud in Obamacare enrollment since last year.
The Paragon Health Institute, a right-leaning research group with close ties to the administration, has published reports estimating that more than a quarter of Obamacare enrollees were improperly signed up. That research helped inform changes in how people sign up for coverage that were passed into law last year as part of the large Republican tax bill. But those changes do not kick in until after the election.
The administration also tried to add new requirements to the enrollment process through regulation, but the changes have been stopped by a court.
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