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    "original_url": "https:\/\/www.nytimes.com\/2026\/09\/22\/us\/politics\/aca-obamacare-vance-fraud.html?emc=edit_na_20260922&nl=breaking-news&segment_id=226916",
    "parsed_content": "Trump AdministrationN.I.H. GrantsGreenland DealDefense of A.I.Voting by MailApproval RatingAdvertisementSKIP ADVERTISEMENTSupported bySKIP ADVERTISEMENTTrump Officials Eject 750,000 From Obamacare Markets, Claiming FraudVice President JD Vance said the measure would save the government $2.2 billion.Listen \u00b7 8:08 min Share full articleVice President JD Vance at the White House earlier this month. \u201cWe\u2019re actually making sure that the people receiving Obamacare subsidies are actually entitled to receive them,\u201d he said on Tuesday.Credit...Doug Mills\/The New York TimesBy Margot Sanger-KatzSarah Kliff and Christopher RowlandReporting from WashingtonSept. 22, 2026Updated 7:33 p.m. ETSee more of our coverage in your search results.Encuentra m\u00e1s de nuestra cobertura en los resultados de b\u00fasqueda. Add The New York Times on GoogleAgrega The New York Times en Google 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 real people.\u201cWe\u2019re actually making sure that the people receiving Obamacare subsidies are actually entitled to receive them,\u201d Mr. Vance said at a news conference, using a different name for the health law. He estimated that removing the targeted enrollees would save the government $2.2 billion. The announcement was the latest initiative by an anti-fraud task force Mr. Vance leads that has often turned its efforts toward federal health programs. In recent months, the task force has been involved in withholding billions in Medicaid funding from Minnesota and California, contending that the states had not adequately combated fraud.Obamacare enrollment has already declined significantly this year, as the cost of the plans has risen, a potential political risk for Republicans heading into midterm elections in which voters are worried about affordability and the cost of living.AdvertisementSKIP ADVERTISEMENTCongressional Democrats immediately criticized the Trump administration\u2019s announcement on Tuesday as an unjustified move to dismantle Affordable Care Act, known as Obamacare.\u201cUsing the false pretext of fighting fraud to strip Americans of their healthcare is as cynical as it is cruel,\u201d Representative Nancy Pelosi, Democrat of California, posted on social media.The dropped enrollees account for about 4 percent of the 19 million Americans who receive coverage through the marketplaces created by the Affordable Care Act. Many live close to the poverty line.Under the law, people who earn more than four times the poverty limit \u2014 around $64,000 for a single person \u2014 are ineligible for subsidies to help them afford premiums. But people who earn less than the federal poverty limit \u2014 around $16,000 a year \u2014 are also ineligible. 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.The Trump administration asked health plans to verify eligibility for nearly 1.2 million people who were signed up by a broker and missing a Social Security number or immigration papers, according to a spokesperson for the Centers for Medicare and Medicaid Services, which oversees Obamacare.AdvertisementSKIP ADVERTISEMENTOfficials then narrowed that list to people who had not filed insurance claims, had no record of contacting the insurer about the coverage and whose premiums were fully covered by government subsidies.Obamacare enrollees had 30 days to respond to their insurers. Those who were flagged under the criteria and did not respond to their health plan\u2019s outreach had their coverage canceled.The spokesperson said that if a \u201clegitimate consumer\u201d believed he or she was affected by the cancellations, the person could get coverage reinstated by providing the Obamacare marketplace with their Social Security number.Mr. Vance said the 750,000 who would lose coverage were a mix of people who did not meet the eligibility requirements or did not exist.Officials said they planned to investigate an additional 440,000 enrollees who may also fall into one of those categories.AdvertisementSKIP ADVERTISEMENT\u201cThey had something about their story that was a little bit different than what we expected from the 100 percent fraud story,\u201d Dr. Mehmet Oz, the administrator of the Centers for Medicare and Medicaid Services, said of the Obamacare enrollees the administration would allow to remain enrolled. \u201cWe\u2019re giving them another chance.\u201dIn statements, two large insurance industry groups, America\u2019s Health Insurance Plans and the Blue Cross Blue Shield Association, said they welcomed efforts to reduce fraud in the marketplaces.There is evidence that ineligible low-income people have enrolled in coverage in recent years, either because they overestimated their expected income or because a broker coached them to do so to obtain coverage. The Congressional Budget Office estimates that there were around 2.3 million such people in 2025.There is also evidence that some insurance brokers, who earn commissions for each enrollment, 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 \u2014 in many cases switching people from the plan they chose to another plan to harvest commissions. The Trump administration recertified those brokers last year, but has since removed more brokers from the program.\u201cWe absolutely found that there was a fair amount of unauthorized activity,\u201d said Ellen Montz, who oversaw the Obamacare marketplaces for the Biden administration. She described an uptick in fraudulent enrollments that started in 2024, and said that in response, the Biden administration cracked down on brokers and began requiring more documents during online enrollment.AdvertisementSKIP ADVERTISEMENTAt 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 had been found guilty of bribing homeless people to enroll in Obamacare plans, so they could earn commissions. Both were sentenced in February to 20 years of jail time.Cynthia Cox, the director of a program on the Affordable Care Act at KFF, a health research group, said that the administration\u2019s action appeared to fall outside the normal process for verifying eligibility. \u201cThere is widespread agreement that unauthorized enrollments should be canceled,\u201d she said. \u201cThe question is whether these were all indeed unauthorized enrollments and whether this was the appropriate process for determining whether an enrollee was legitimate or not.\u201dMs. Cox and Ms. Montz both noted that problems with the data of enrollees did not necessarily constitute fraud.\u201cI would absolutely foresee that totally legitimate enrollments are going to get cut off here,\u201d Ms. Montz said.Enrollment in coverage sold in the Affordable Care Act marketplaces had already fallen by several million this year, after Congress declined to extend temporary funding that had made coverage less expensive. 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.AdvertisementSKIP ADVERTISEMENTThough there is little current data on the uninsured rate now, estimates from the C.B.O. and other analysts suggest that most of the lower-income people who have lost Obamacare coverage will remain uninsured.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. The research noted disproportionate sign-ups among low-income enrollees, enrollments with missing data, and a subset of enrollees who never made medical claims. 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.AdvertisementSKIP ADVERTISEMENT",
    "published_at": "2026-09-22T16:39:50+00:00",
    "author_name": "Margot Sanger-Katz, Sarah Kliff and Christopher Rowland",
    "site_name": "The New York Times",
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    "ai_headline": "Trump Officials Eject 750,000 From Obamacare Markets, Claiming Fraud",
    "ai_simplified_title": "Trump Administration Ejects 750,000 From Obamacare Markets Claiming Fraud",
    "ai_excerpt": "The Trump administration has ejected over 750,000 enrollees from Affordable Care Act insurance marketplaces, citing fraud and ineligible recipients. Vice President JD Vance announced the measure, claiming it would save $2.2 billion, while Democrats criticized it as a move to dismantle Obamacare.",
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