US Vice President JD Vance and other Trump administration officials have announced plans to remove about 760,000 people from Affordable Care Act coverage after determining that they were fraudulently enrolled in the government health programme.
Vance made the announcement during a White House press briefing on Tuesday, saying officials would also carry out “additional verification” on about 419,000 other enrollees suspected of being improperly registered.
The administration is also suspending insurance brokers accused of wrongly enrolling people in ACA plans.
Officials said the measures are expected to save about $2.2bn in federal spending. The White House anti-fraud task force, headed by Vance, is working with the Department of Health and Human Services and the Centers for Medicare and Medicaid Services on the crackdown.
“This is what the fraud task force is all about,” Vance said, flanked by CMS Administrator Mehmet Oz and other senior officials. “Saving the American taxpayers money, and on the other hand, ensuring that these programs that are very important are protected from waste and fraud.
Oz said officials identified the allegedly fraudulent enrolments by examining factors including whether the individuals had used healthcare services. He said the review found that many of the enrollees appeared to be fictitious.
He also announced a six-month suspension on the approval of new insurance brokers seeking to sell ACA plans.
The Wall Street Journal first reported the administration’s plans to remove the enrollees and suspend some brokers. Earlier this year, administration officials told The Washington Post that the anti-fraud task force was investigating suspected fraud involving ACA enrolment.
About 19 million people were enrolled in health plans offered through the ACA exchanges as of June, according to HHS officials.
ACA enrolment increased significantly during the administration of former President Joe Biden but has fallen by more than one million since President Donald Trump returned to office. Officials expect the number to decline further this year.
The crackdown forms part of Vance and Trump’s broader effort to reduce federal spending, with healthcare programmes among the areas receiving particular attention.
Vance and Trump have also repeatedly criticised the Affordable Care Act, the healthcare law established under former President Barack Obama and congressional Democrats in 2010.
The law has been credited with helping reduce the US uninsured rate to historic lows. However, Democrats and some healthcare policy experts have argued that Trump administration policies, including the termination of pandemic-era subsidies that reduced the cost of ACA plans for many people, have pushed some Americans out of the programme.
Jason Levitis, a former senior Treasury Department official under Obama who helped develop and implement ACA policies, acknowledged the administration’s efforts to tackle fraud but criticised the scale and manner of Tuesday’s announcement.
He described the move as “chaotic” and questioned whether legitimate enrollees could lose their coverage during the crackdown.
“Throwing three quarters of a million people into this bucket of ‘Your coverage is canceled’ and then having to figure it out later is a big concern,” said Levitis, who is now a senior fellow at the Urban Institute.
He argued that the administration could have used a more structured approach, including lessons from states operating their own ACA exchanges, which have reported lower levels of fraud.
Some critics also described the announcement as a distraction ahead of the midterm elections and compared the anti-fraud campaign with the administration’s efforts to reduce spending on Medicaid and other healthcare programmes.
“Families need coverage they can afford and count on when they get sick,” Brad Woodhouse, president of liberal-leaning advocacy group Protect Our Care, said in a statement Tuesday. “Vance’s task force won’t accomplish that.”
Republicans, however, have argued that the decline in ACA enrolment reflects efforts to eliminate waste and fraud after Democrats expanded the programme without doing enough to scrutinise those signing up.
Some conservative lawmakers and policy experts have also called for stronger action, arguing that fraudulent enrolment increased after pandemic-era measures made it easier for people to obtain coverage.
Brian Blase, founder of the conservative Paragon Health Institute, welcomed the administration’s decision.
His organisation estimated earlier this year that around six million ACA enrollees were fraudulent, including so-called “phantom enrollees” who were either unaware they had been signed up or were allegedly fabricated by brokers.
“The Trump administration’s actions to suspend brokers engaged in these activities and disenroll phantoms is welcome and will save taxpayers billions of dollars each year,” said Blase, who served as an economic aide to Trump during his first administration.
Oz has previously said CMS believes as much as one-third of ACA enrolment could be improper.
“If you care about the ACA, then you’ll want us to take the fraud out,” Oz said at a White House briefing in June.
During Tuesday’s briefing, Oz also highlighted several convicted insurance executives accused of enrolling tens of thousands of people improperly in ACA plans and using the proceeds to finance their lifestyles.
At one point, Oz described one of the convicted fraudsters as having “a very punchable face,” while Kim Brandt, a senior CMS official involved in the crackdown, displayed a photograph.
Trump administration officials said they had also changed the government’s approach to detecting fraud.
They said agencies were moving away from the traditional “pay and chase” model, in which payments were made before fraudulent activity was detected and officials later attempted to recover the funds.
The new approach, which officials referred to as a “stop and catch” model, uses AI-powered analytics and pattern recognition to identify suspicious activity and potential fraudsters earlier.
“We’ve learned something: Fraud doesn’t stand still,” Chris Klomp, a senior HHS official, said at Tuesday’s briefing.
