Trump administration drops 760,000 Americans from ACA coverage, citing fraud

Citing widespread fraud, JD Vance and Dr. Mehmet Oz announced 760,000 Americans had been kicked off health insurance purchased in the federal ACA marketplace. The move raises lots of questions.

STEVE INSKEEP, HOST: The Trump administration says it canceled health insurance for what it calls phantom enrollees. Officials are not sharing details of how they decided the 760,000 names did not represent real people. NPR's Selena Simmons-Duffin reports. SELENA SIMMONS-DUFFIN, BYLINE: The enrollments in question were on HealthCare.gov, the marketplace set up by the Affordable Care Act, also known as Obamacare. This is for people who don't get insurance from their job or a public program, like Medicare or Medicaid. They can go on HealthCare.gov and buy a private health insurance plan, oftentimes with premium subsidies paid for by the federal government. On Tuesday, Vice President Vance said fraudster brokers were signing up, quote, "phantom people" into these plans. He announced moves to punish brokers, like stopping new ones from registering for the upcoming open enrollment and changing enrollment processes. He said the government would save more than $2 billion in subsidies it would have been sending to insurance companies for the enrollments it canceled. CYNTHIA COX: There could have been collateral damage here. SIMMONS-DUFFIN: Cynthia Cox is the director of the program on the Affordable Care Act at KFF, a nonpartisan health research organization. She heard some time ago from contacts in the health insurance industry that this effort was underway. COX: What we know is that the administration sent a list of about a million people to health insurance companies and asked these health insurance companies to try to make contact with those people. And if those people did not respond within 30 days, they ultimately had their plan canceled. SIMMONS-DUFFIN: She says there is fraud in the marketplace, but it's also entirely possible that qualified people had their health insurance canceled. Cox says, for instance, if someone didn't file a claim, they might have just been healthy, and if they didn't respond to the notice in time, they might have just missed it. COX: People move, you know, they don't check their email or their voicemail or, you know, that sort of thing. SIMMONS-DUFFIN: Vance and other Trump administration officials said they were looking at 400,000 more enrollees who might get their plans canceled. The Centers for Medicare & Medicaid Services, which runs HealthCare.gov and the government's other healthcare programs, did not respond to NPR's questions by airtime about the process it's using and what happens if there were mistakes and people had their plans canceled in error. Selena Simmons-Duffin, NPR News, Washington. Copyright © 2026 NPR. All rights reserved. Visit our website terms of use and permissions pages at www.npr.org for further information. Accuracy and availability of NPR transcripts may vary. Transcript text may be revised to correct errors or match updates to audio. Audio on npr.org may be edited after its original broadcast or publication. The authoritative record of NPR’s programming is the audio record.

STEVE INSKEEP, HOST: The Trump administration says it canceled health insurance for what it calls phantom enrollees. Officials are not sharing details of how they decided the 760,000 names did not represent real people. NPR's Selena Simmons-Duffin reports. SELENA SIMMONS-DUFFIN, BYLINE: The enrollments in question were on HealthCare.gov, the marketplace set up by the Affordable Care Act, also known as Obamacare. This is for people who don't get insurance from their job or a public program, like Medicare or Medicaid. They can go on HealthCare.gov and buy a private health insurance plan, oftentimes with premium subsidies paid for by the federal government. On Tuesday, Vice President Vance said fraudster brokers were signing up, quote, "phantom people" into these plans. He announced moves to punish brokers, like stopping new ones from registering for the upcoming open enrollment and changing enrollment processes. He said the government would save more than $2 billion in subsidies it would have been sending to insurance companies for the enrollments it canceled. CYNTHIA COX: There could have been collateral damage here. SIMMONS-DUFFIN: Cynthia Cox is the director of the program on the Affordable Care Act at KFF, a nonpartisan health research organization. She heard some time ago from contacts in the health insurance industry that this effort was underway. COX: What we know is that the administration sent a list of about a million people to health insurance companies and asked these health insurance companies to try to make contact with those people. And if those people did not respond within 30 days, they ultimately had their plan canceled. SIMMONS-DUFFIN: She says there is fraud in the marketplace, but it's also entirely possible that qualified people had their health insurance canceled. Cox says, for instance, if someone didn't file a claim, they might have just been healthy, and if they didn't respond to the notice in time, they might have just missed it. COX: People move, you know, they don't check their email or their voicemail or, you know, that sort of thing. SIMMONS-DUFFIN: Vance and other Trump administration officials said they were looking at 400,000 more enrollees who might get their plans canceled. The Centers for Medicare & Medicaid Services, which runs HealthCare.gov and the government's other healthcare programs, did not respond to NPR's questions by airtime about the process it's using and what happens if there were mistakes and people had their plans canceled in error. Selena Simmons-Duffin, NPR News, Washington. Copyright © 2026 NPR. All rights reserved. Visit our website terms of use and permissions pages at www.npr.org for further information. Accuracy and availability of NPR transcripts may vary. Transcript text may be revised to correct errors or match updates to audio. Audio on npr.org may be edited after its original broadcast or publication. The authoritative record of NPR’s programming is the audio record.

The Trump administration says it canceled health insurance for what it calls phantom enrollees. Officials are not sharing details of how they decided the 760,000 names did not represent real people. NPR's Selena Simmons-Duffin reports. SELENA SIMMONS-DUFFIN, BYLINE: The enrollments in question were on HealthCare.gov, the marketplace set up by the Affordable Care Act, also known as Obamacare. This is for people who don't get insurance from their job or a public program, like Medicare or Medicaid. They can go on HealthCare.gov and buy a private health insurance plan, oftentimes with premium subsidies paid for by the federal government. On Tuesday, Vice President Vance said fraudster brokers were signing up, quote, "phantom people" into these plans. He announced moves to punish brokers, like stopping new ones from registering for the upcoming open enrollment and changing enrollment processes. He said the government would save more than $2 billion in subsidies it would have been sending to insurance companies for the enrollments it canceled. CYNTHIA COX: There could have been collateral damage here. SIMMONS-DUFFIN: Cynthia Cox is the director of the program on the Affordable Care Act at KFF, a nonpartisan health research organization. She heard some time ago from contacts in the health insurance industry that this effort was underway. COX: What we know is that the administration sent a list of about a million people to health insurance companies and asked these health insurance companies to try to make contact with those people. And if those people did not respond within 30 days, they ultimately had their plan canceled. SIMMONS-DUFFIN: She says there is fraud in the marketplace, but it's also entirely possible that qualified people had their health insurance canceled. Cox says, for instance, if someone didn't file a claim, they might have just been healthy, and if they didn't respond to the notice in time, they might have just missed it. COX: People move, you know, they don't check their email or their voicemail or, you know, that sort of thing. SIMMONS-DUFFIN: Vance and other Trump administration officials said they were looking at 400,000 more enrollees who might get their plans canceled. The Centers for Medicare & Medicaid Services, which runs HealthCare.gov and the government's other healthcare programs, did not respond to NPR's questions by airtime about the process it's using and what happens if there were mistakes and people had their plans canceled in error. Selena Simmons-Duffin, NPR News, Washington. Copyright © 2026 NPR. All rights reserved. Visit our website terms of use and permissions pages at www.npr.org for further information. Accuracy and availability of NPR transcripts may vary. Transcript text may be revised to correct errors or match updates to audio. Audio on npr.org may be edited after its original broadcast or publication. The authoritative record of NPR’s programming is the audio record.

The Trump administration says it canceled health insurance for what it calls phantom enrollees. Officials are not sharing details of how they decided the 760,000 names did not represent real people. NPR's Selena Simmons-Duffin reports. SELENA SIMMONS-DUFFIN, BYLINE: The enrollments in question were on HealthCare.gov, the marketplace set up by the Affordable Care Act, also known as Obamacare. This is for people who don't get insurance from their job or a public program, like Medicare or Medicaid. They can go on HealthCare.gov and buy a private health insurance plan, oftentimes with premium subsidies paid for by the federal government. On Tuesday, Vice President Vance said fraudster brokers were signing up, quote, "phantom people" into these plans. He announced moves to punish brokers, like stopping new ones from registering for the upcoming open enrollment and changing enrollment processes. He said the government would save more than $2 billion in subsidies it would have been sending to insurance companies for the enrollments it canceled. CYNTHIA COX: There could have been collateral damage here. SIMMONS-DUFFIN: Cynthia Cox is the director of the program on the Affordable Care Act at KFF, a nonpartisan health research organization. She heard some time ago from contacts in the health insurance industry that this effort was underway. COX: What we know is that the administration sent a list of about a million people to health insurance companies and asked these health insurance companies to try to make contact with those people. And if those people did not respond within 30 days, they ultimately had their plan canceled. SIMMONS-DUFFIN: She says there is fraud in the marketplace, but it's also entirely possible that qualified people had their health insurance canceled. Cox says, for instance, if someone didn't file a claim, they might have just been healthy, and if they didn't respond to the notice in time, they might have just missed it. COX: People move, you know, they don't check their email or their voicemail or, you know, that sort of thing. SIMMONS-DUFFIN: Vance and other Trump administration officials said they were looking at 400,000 more enrollees who might get their plans canceled. The Centers for Medicare & Medicaid Services, which runs HealthCare.gov and the government's other healthcare programs, did not respond to NPR's questions by airtime about the process it's using and what happens if there were mistakes and people had their plans canceled in error. Selena Simmons-Duffin, NPR News, Washington. Copyright © 2026 NPR. All rights reserved. Visit our website terms of use and permissions pages at www.npr.org for further information. Accuracy and availability of NPR transcripts may vary. Transcript text may be revised to correct errors or match updates to audio. Audio on npr.org may be edited after its original broadcast or publication. The authoritative record of NPR’s programming is the audio record.

SELENA SIMMONS-DUFFIN, BYLINE: The enrollments in question were on HealthCare.gov, the marketplace set up by the Affordable Care Act, also known as Obamacare. This is for people who don't get insurance from their job or a public program, like Medicare or Medicaid. They can go on HealthCare.gov and buy a private health insurance plan, oftentimes with premium subsidies paid for by the federal government. On Tuesday, Vice President Vance said fraudster brokers were signing up, quote, "phantom people" into these plans. He announced moves to punish brokers, like stopping new ones from registering for the upcoming open enrollment and changing enrollment processes. He said the government would save more than $2 billion in subsidies it would have been sending to insurance companies for the enrollments it canceled. CYNTHIA COX: There could have been collateral damage here. SIMMONS-DUFFIN: Cynthia Cox is the director of the program on the Affordable Care Act at KFF, a nonpartisan health research organization. She heard some time ago from contacts in the health insurance industry that this effort was underway. COX: What we know is that the administration sent a list of about a million people to health insurance companies and asked these health insurance companies to try to make contact with those people. And if those people did not respond within 30 days, they ultimately had their plan canceled. SIMMONS-DUFFIN: She says there is fraud in the marketplace, but it's also entirely possible that qualified people had their health insurance canceled. Cox says, for instance, if someone didn't file a claim, they might have just been healthy, and if they didn't respond to the notice in time, they might have just missed it. COX: People move, you know, they don't check their email or their voicemail or, you know, that sort of thing. SIMMONS-DUFFIN: Vance and other Trump administration officials said they were looking at 400,000 more enrollees who might get their plans canceled. The Centers for Medicare & Medicaid Services, which runs HealthCare.gov and the government's other healthcare programs, did not respond to NPR's questions by airtime about the process it's using and what happens if there were mistakes and people had their plans canceled in error. Selena Simmons-Duffin, NPR News, Washington. Copyright © 2026 NPR. All rights reserved. Visit our website terms of use and permissions pages at www.npr.org for further information. Accuracy and availability of NPR transcripts may vary. Transcript text may be revised to correct errors or match updates to audio. Audio on npr.org may be edited after its original broadcast or publication. The authoritative record of NPR’s programming is the audio record.

SELENA SIMMONS-DUFFIN, BYLINE: The enrollments in question were on HealthCare.gov, the marketplace set up by the Affordable Care Act, also known as Obamacare. This is for peo