The Trump administration is removing roughly 760,000 people from Affordable Care Act health plans as part of a sweeping crackdown on enrollments it says are fraudulent, unauthorized or otherwise ineligible.
Vice President JD Vance announced the action Tuesday as part of the White House Task Force to Eliminate Fraud, which he chairs. Administration officials estimate canceling the enrollments and associated federal subsidies will save taxpayers about $2.2 billion.
“These are not real people. We’re not paying insurance for non-existent ghosts,” Centers for Medicare and Medicaid Services Administrator Dr. Mehmet Oz said during a press conference.
The administration says the affected enrollments include people who could not verify citizenship or immigration status, people who may have been signed up without their knowledge and others whose eligibility could not be verified. Reuters reported that CMS canceled about 315,000 policies in August, affecting approximately 760,000 people.
Vance said the effort is aimed at fraud rather than taking legitimate health benefits away from Americans.
“This is not about cutting off anybody from their benefits. It’s about cutting off fraudsters from stealing from these programs,” Vance said Tuesday.
Vance and Oz said officials have taken steps to avoid removing legitimate enrollees. According to the administration, many of the people identified in the crackdown had filed no insurance claims, lacked identifying information or failed to respond to attempts to verify their eligibility.
“We are putting ourselves under an extraordinary burden of proof,” Vance said. “So those 750,000 people are people that we feel confident either don’t know that they’re enrolled in the program, aren’t using the program at all, are unaware of it, or … are potentially phantom people who are enrolled against their will, or maybe they don’t even exist.”
The administration is also tightening oversight of insurance brokers and agents who enroll people in ACA plans. CMS has imposed a six-month freeze on new broker registrations while it reviews enrollment practices. Reuters reported that 569 brokers have been barred from participating after the government identified suspicious enrollment activity, including applications lacking Social Security numbers and unusually high application volumes.
The crackdown comes as Republicans and Democrats continue to clash over healthcare affordability ahead of the November midterm elections.
Republicans argue that enrollment growth under the Biden administration came with insufficient safeguards against improper sign-ups, particularly after enhanced federal subsidies made some ACA plans available with little or no premium cost. CMS has previously said those conditions created opportunities for improper enrollment.
The Justice Department has also pursued ACA-related fraud cases. Earlier this year, it announced that a Florida insurance brokerage had agreed to plead guilty for its role in an ACA enrollment fraud scheme as part of a broader series of healthcare fraud cases.
Critics, however, argue the administration's approach could result in eligible Americans losing health insurance.
Democratic-aligned advocacy group Protect Our Care called the latest action a “smokescreen” and accused the administration of using fraud enforcement to make it more difficult for people to obtain and maintain ACA coverage.
“Families need coverage they can afford and count on when they get sick. Vance’s task force won’t accomplish that. It’s a smokescreen for an administration whose sole mission is to make it harder to get and stay covered but to shower billionaires with tax breaks instead,” Protect Our Care President Brad Woodhouse said in a statement.
The dispute comes amid broader changes to the ACA marketplace. Enhanced subsidies enacted during the COVID era have expired, and enrollment has declined as consumers face higher premiums. Approximately 19.2 million people had active ACA exchange coverage in early 2026, according to federal figures cited by the Associated Press.
The administration says Tuesday’s action is intended to separate legitimate ACA customers from fraudulent or unauthorized enrollments. Its critics contend the tougher verification and enrollment rules risk sweeping eligible people into the crackdown as well.
