Story summary
Dr. Mehmet Oz, administrator for the Centers for Medicare & Medicaid Services (CMS), is urging health insurers to work exclusively with brokers who record conversations with Affordable Care Act (ACA) applicants. This move comes as part of a broader effort by the Trump administration to combat unauthorized enrollments, which officials claim have cost taxpayers billions of dollars. Vice President JD Vance announced Tuesday that 750,000 fraudulent recipients enrolled in ACA would be removed, potentially saving American taxpayers $2.2 billion annually.
Oz told Fox News Digital that these accounts are "phantom," with no human involvement; inquiries to the supposed enrollees yielded no responses or verifiable information such as Social Security numbers. The Washington Examiner reported that just a few years after the ACA exchanges opened in 2013, the Government Accountability Office found that investigators could create fictitious enrollments, leading to significant financial losses for taxpayers.
Critics argue that efforts like Vance's anti-fraud push may unfairly deprive deserving Americans of healthcare benefits and increase insurance costs. However, proponents contend it is necessary to ensure the integrity of the ACA system.
Written for “ObamaCare Fraud Crackdown” on 2026-10-08,
grounded in this article and the 1 other(s) covering the same event.
Vice President JD Vance recently announced that the Trump administration would end subsidy payments for 760,000 fraudulent health insurance enrollments made through the federally administered Affordable Care Act exchanges, saving taxpayers $2.2 billion a year.
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administration → announce → billion
Now Democrats are attacking Vance for taking healthcare away from deserving Americans and raising healthcare costs for everyone else.
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Democrats → attack → everyone
But there is no evidence Vance’s anti-fraud efforts have deprived anyone of healthcare, and to the extent insurance premiums will increase because of them, that is an indictment of Obamacare, not the Trump administration.
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that → be → Obamacare
If anything, the Trump administration should turn its focus to states and force them to perform the same anti-fraud procedures the Trump administration just applied to the federal exchanges.
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administration → turn → exchanges
Just a few short years after the exchanges first opened in 2013, the Government Accountability Office released a report finding that investigators were able to create fictitious enrollments, causing thousands of taxpayer dollars to be sent directly to insurance companies for health insurance that was never provided.
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that → open → insurance
The scam works like this: health insurance brokers use stolen or fake Social Security numbers to sign fictitious people up for insurance.
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brokers → work → insurance
If the fake applicant has just the right income level, their premium is subsidized entirely by taxpayers, so health insurance companies have no reason to bill them.
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companies → have → them
The brokers then get a fee from health insurance companies for every new applicant they enroll.
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they → get → applicant
In a sense, it’s a victimless crime.
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it → ’ → sense
The broker gets a fee, insurance companies get a monthly check from the government for an enrollee who will never file a claim, and insurers can then lower premiums for everyone else.
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insurers → get → everyone
We are all stuck paying the bill for fraudulent broker fees and inflated insurance company profits that have to be paid for through either higher taxes or more government borrowing, which leads to inflation.
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which → pay → inflation
ACA fraud was only made worse during COVID-19 when Democrats boosted the exchange subsidy payments, meaning a wider band of income levels could have their monthly premiums covered entirely by taxpayers.
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premiums → make → taxpayers
Before COVID, about 15% of ACA exchange plans paid no premium.
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% → pay → premium
After the COVID bonus, the number of no-premium subsidy recipients skyrocketed to more than 40%.
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number → skyrocket → %
This created a huge opportunity for fraud.
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This → create → fraud
Vance’s efforts are now reversing that.
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efforts → reverse → that
Before an enrollment was canceled, the Centers for Medicare and Medicaid Services confirmed that it met four criteria: an agent or broker had submitted the application without a Social Security number or immigration number; federal subsidies covered the entire premium; the enrollee had no medical claims; and the insurer had no record of contact with the enrollee.
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insurer → cancel → enrollee
The agency then required the insurer to send notices through two different communication methods, giving the enrollee an opportunity to respond.
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agency → require → opportunity
Only after receiving no response was the enrollment deemed unauthorized and canceled.
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enrollment → receive → response
Legitimate enrollees could still have their coverage reinstated by contacting the federal exchange and providing verified identifying information.
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coverage → have → information
But of course, Democrats are calling foul.
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Democrats → call → course
Former Biden administration officials say they “absolutely foresee that totally legitimate enrollments are going to get cut off here.”
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enrollments → say → ?
But none have yet been identified.
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none → identify → ?
The insurance companies themselves are also complaining, noting that disenrolling those who make no medical claims would inevitably increase average medical costs for those who remain covered, meaning insurance companies would have to raise premiums on the remaining real enrollees to make up the difference.
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companies → complain → difference
This may be true, but it only demonstrates why the entire ACA model was flawed to begin with.
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model → demonstrate → ?
Obamacare funnels taxpayer money to insurance companies while insulating consumers from the true cost of coverage.
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Obamacare → funnel → coverage
Expanding subsidies hides those costs rather than reducing them, rewarding insurers and brokers for enrolling more people without ensuring taxpayers get value for their money.
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taxpayers → expand → money
Reform should instead expand competition and give patients greater control over their healthcare dollars.
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Reform → expand → dollars
A system that needs payments for fictitious patients to keep premiums affordable needs fundamental reform.
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that → need → reform
At a bare minimum, what should happen is that Vance’s successful anti-fraud efforts at the federal level be carried to the states as well.
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efforts → happen → states
The purge of fraudulent ACA enrollments was conducted only in those states with federally administered exchanges.
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purge → conduct → exchanges
State-based exchanges such as those in California, New York, and Illinois still have thousands of fraudulent accounts receiving subsidies.
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exchanges → base → subsidies
That must end.
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That → end → ?
Fighting fraud alone will not balance federal or state budgets.
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Fighting → fight → budgets
But leaders who protect taxpayers from abuse can earn the trust needed to confront harder fiscal choices.
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who → protect → choices
Americans are more likely to accept difficult reforms when those asking for sacrifice first demonstrate that the government spends their money honestly and responsibly.
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government → accept → money
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