More Than 760,000 People Have Lost ACA Marketplace Coverage As Federal Officials Target Unauthorized Enrollments
The Trump administration has canceled Affordable Care Act marketplace coverage for more than 760,000 people as part of a sweeping federal effort targeting what officials say are unauthorized or improper enrollments.
The Centers for Medicare & Medicaid Services announced Tuesday that approximately 315,000 enrollments covering more than 760,000 individuals were canceled Aug. 31 after reviews conducted by CMS and health insurance companies. The agency estimates the move will return roughly $2.2 billion in federal premium tax credits.
Vice President JD Vance, who leads the White House Task Force to Eliminate Fraud, announced the crackdown alongside CMS Administrator Mehmet Oz.
“We’re actually making sure that the people receiving Obamacare subsidies are actually entitled to receive them,” Vance said during the Sept. 22 announcement. The White House has characterized the effort as part of a broader campaign against fraud in federal programs.
CMS Targets Brokers And Unauthorized Enrollments
Federal officials say the affected enrollments included cases in which consumers may have been signed up without authorization and applications that lacked information needed to verify eligibility.
CMS said it has identified patterns of suspicious activity involving some insurance agents and brokers. Since January, the agency has sent termination notices to more than 200 agents and brokers and issued another 569 notices of intent to terminate agreements involving brokers accused of submitting applications without key identifying information, including Social Security numbers.
The agency is also temporarily blocking new agents and brokers without active 2026 agreements from registering for the 2027 marketplace year. Existing brokers will be required to verify their identities again, and CMS is adding requirements intended to confirm consumers have authorized brokers to act on their behalf.
Administration officials have also said hundreds of thousands of additional marketplace enrollments are undergoing further eligibility checks.
Experts Question How Consumers Were Identified
Health policy experts agree that unauthorized enrollment should be addressed but have raised questions about whether the federal review could also terminate coverage for eligible consumers.
Cynthia Cox, vice president and director of the ACA program at health policy organization KFF, said there is little dispute that genuinely fraudulent enrollments should be canceled. Her concern centers on how the government determined which enrollments were improper and whether every person removed actually belonged in that category.
Ellen Montz, who previously helped oversee ACA marketplaces at CMS during the Biden administration, has also warned that legitimate consumers could lose coverage during the process.
CMS maintains that the canceled cases were confirmed as unauthorized following reviews with insurers. The agency says it will continue investigating suspected improper enrollments and recovering federal subsidies tied to confirmed cases.
ACA Enrollment Already Falling
The crackdown comes during a year in which ACA marketplace enrollment has already declined substantially.
KFF reported that marketplace enrollment dropped from about 22.1 million people in 2025 to 19.2 million in February 2026. The decline followed the expiration of enhanced federal premium tax credits at the end of 2025, which caused premium payments to rise for many consumers.
That means the latest cancellations arrive as millions of Americans are already navigating higher insurance costs and changes in marketplace coverage.
Federal officials say the new enforcement measures are intended to protect both consumers and taxpayers from unauthorized enrollment. The debate now centers on whether the government’s review process can distinguish fraudulent or improper applications from legitimate consumers without interrupting coverage for people who remain eligible.
