Trump admin uncovers $10B in Obamacare fraud, drops nearly 3 million ineligible enrolees
WASHINGTON, DC: The Trump administration's Department of Health and Human Services has identified an estimated $10 billion in fraudulent Affordable Care Act enrollments and removed nearly three million ineligible recipients from the program's rolls, according to a report obtained by Fox News Digital.
The findings are part of a broader anti-fraud effort spanning the federal government, prompted by a sharp rise in Obamacare enrollment during the Biden administration. Enrollment in the program climbed from roughly 10 million people at the start of Biden's term to a peak of 22 million in 2024, a surge that triggered a review into the accuracy of the underlying claims.
Report cites relaxed verification standards, 'phantom' enrollments
According to the report, the Biden administration loosened eligibility checks and income verification requirements while expanding year-round enrollment opportunities.
Some applicants lied about their income to get coverage, investigators found. In other cases, insurance brokers signed people up for Obamacare plans without their knowledge, a practice the report calls “phantom enrollment.” Some enrollees also received subsidies for which they were not eligible.
“By our estimate, improper, phantom, and fraudulent enrollment peaked at 5.6 million individuals in 2025,” the report states, adding that there are 2.6 million such enrollments left to address, including more than a million tied to applications without a Social Security number.
The administration estimated that the improper enrollments cost taxpayers about $10 billion between 2021 and 2024.
HHS restores income checks, says effort to continue
In response, HHS has restored income verification requirements, ended certain special enrollment periods, begun checking for duplicate Medicaid enrollments, and launched investigations into brokers accused of enrolling people without their consent.
The agency said about 19.2 million people currently remain enrolled in the program, down from its 2024 peak.
"Preserving the fiscal and programmatic integrity of the ACA Exchanges is key to safeguarding taxpayer-funded resources for those that truly need them," the report says.
"The federal government paying brokers to enroll individuals without their knowledge is not."
"The Trump administration continues to aggressively root out fraud, waste, abuse, and corruption by promulgating new regulations to improve program integrity, investigating suspected improper or fraudulent enrollment, and taking action against agents and brokers committing fraud."
The findings come as lawmakers in both parties continue to debate the future of the Affordable Care Act amid broader discussions over healthcare costs and program oversight.
Right now, about 19.2 million people remain on the Obamacare rolls.
