Vice President JD Vance and Dr. Mehmet Oz, the head of the Centers for Medicare and Medicaid Services, held a press conference Tuesday to announce that they’d stopped $2.2 billion in fraud. But the fraud in question wasn’t the latest pay-for-play scandal ensnaring Republican Senator Susan Collins, or the literally countless ways that the Trump family is using the presidency to enrich itself. Instead, Vance declared that his anti-fraud task force had found 750,000 people who’d signed up for insurance through the Affordable Care Act marketplaces and were wrongly receiving federal subsidies for their plans—either because the person was ineligible or didn’t actually exist.
The Trump administration has stopped sending the subsidies to health insurance companies for those people, effectively canceling those plans and disenrolling the recipients, who make up about 4 percent of all enrollees. It has also instituted a temporary moratorium on registering brokers who help sign people up for ACA plans—barely two months before open enrollment for next year begins. “We’re actually making sure that the people receiving Obamacare subsidies are actually entitled to receive them,” Vance said, trying to sound sarcastic. As usual, Vance blamed the Biden administration for this alleged fraud.
The entire thing seems like a dog and pony show to distract people from all the bad news surrounding the Republicans ahead of the midterms, from the Collins scandal to Trump’s failed war in Iran to his party’s panic over potentially losing both chambers of Congress. The ACA ejections are likely to save only a vanishingly small fraction of federal government spending—$2.2 billion, Vance claims—while kicking real people off their insurance, all at a time when Trump and his billionaire elite friends are robbing Americans of their tax dollars and a functioning government. And it all relies on a twisted definition of fraud that Republicans are using to distract Americans from the real, consequential swindles of the Trump era.
Like all good diversions, this one has a kernel of truth in it. Because the plans on the state health care marketplaces set up by the ACA—also called Obamacare, which is the term Vance used—can be complicated, the law set up a system that allows insurance brokers to help people navigate the marketplaces and sign them up for plans, for which those brokers earn a commission. In the past, some have signed up ineligible or nonexistent people, or sometimes real people without their knowledge, to earn more in commissions. Doing so is already a crime, and Oz even pointed to a successful prosecution of some of those brokers at the press conference.
So this is a real problem. In fact, the Biden administration decertified 200 brokers engaged in fraudulent behavior during its tenure. But the Trump administration recertified them last year.
When anyone, whether they use a broker or not, signs up for health insurance on one of the ACA marketplaces, the government chips in to subsidize their coverage if they fall within a certain income range, and sends those subsidies straight to the insurance companies. The government is supposed to verify the information, including income, used during sign-up, so what Vance announced the task force had done is, in fact, the government’s job. Vance and Oz announced they were continuing to investigate another 440,000 people.
It’s not clear how many of those kicked off their insurance were believed to be fraudulently enrolled, or enrolled but receiving subsidies they weren’t eligible for. In 2026, the income range for eligibility was about $16,000 to $64,000 for a single person. Sometimes there are innocent mistakes in reporting incomes as well as fraudulent activity, by brokers or others. Workers see their incomes change over the course of a year. If it turns out they earned too much and are no longer eligible for subsidies, then the government can claw those funds back through taxes. If they make too little, they should be signed up for Medicaid, except those who make too little and live in one of the 10 states that haven’t expanded Medicaid under the ACA can, and usually do, go uninsured.
When you look at how Vance’s task force is conducting this investigation, the whole effort becomes a bit questionable. The task force combed the enrollments for people with incomplete information or people who had not gone to the doctor or to a hospital to use their coverage, asked the insurance companies to reach out to them, and then disenroll them if they hadn’t heard back in 30 days.
“There’s no question people who are fraudulently enrolled should have the coverage canceled,” Cynthia Cox, the ACA policy analyst for KFF, the nonprofit health care research, polling, and news organization, said on X. “The question is whether all of these people were fraudulently enrolled and whether this was the appropriate process to identify fraud.” There are many legitimate reasons why people might not have responded in that time frame, she noted.
Anyone who, like me, lets their mail pile up because they can’t sort through the junk to find the real stuff knows that 30 days is a relatively short amount of time to receive and respond to a letter from an insurance company. That’s especially true if you’re used to getting boring Explanation of Benefits letters or other random notifications that those companies are required to send but that don’t really mean much to a layperson. It doesn’t mean those people aren’t real. It could just mean that they’re happily going about their lives while they tossed a letter from their health insurance company in a pile to deal with later, or they ignored a call that looked like a telemarketer, or their email sent any unexpected communication to a spam folder.
Most people, especially younger people in generally good health, hope not to use their health insurance because no one wants to be sick or injured, and probably don’t really think about it most of the time. In fact, that’s how insurance works. Those who pay their premiums but don’t use them are helping to cover people who need more routine care or who have an unpredictable accident. People who don’t use their insurance aren’t always suspect, and kicking them off disrupts the entire system for everyone.
If the worst happens, some of these folks might find out too late, when they’re already at a clerk’s window in an emergency room trying to get care and find out their insurance was canceled. In fact, that’s what many experts expect to happen.
This is just the latest of the many barriers that the Trump administration and Republicans have thrown up to make health care harder to get, including letting enhanced ACA subsidies expire and instituting new Medicaid work requirements. “This so-called task force is nothing more than a bullshit distraction—a political stunt designed to throw even more people off their coverage while pretending to save taxpayers’ money,” said Brad Woodhouse, president of the health care advocacy group Protect Our Care, said in a statement. “At a time when millions of Americans are already losing coverage and facing skyrocketing costs, Vance and this administration are making the crisis exponentially worse.”
The government could put a stop to legitimate ACA fraud by making the exchanges less complicated and getting rid of the need for brokers, or by setting up a public option that no longer requires the government to subsidize private insurance companies at all. Instead, it has set up a maze of hurdles, hoops, and complications that everyday working people have to navigate—creating a situation ripe for a bad-faith administration that’s looking for excuses to gut social spending.
The Trump administration keeps hammering at the idea that the real fraud in America is committed not by our unscrupulous president or greedy corporations, but regular people. This definition of fraud resonates with people because it’s easy to understand and is used to justify limits on programs that could truly help people, leaving them with a broken and shrinking system instead. For decades, Republicans have done it with everything from the decimated welfare system to food stamps, and now they’re going after the relatively new ACA.
But the $2.2 billion they claim to be saving is just a very small part of the nearly $7 trillion the government has already spent this year. And the kind of grift the Trump administration itself commits is harder to grasp but much more damaging, not just in costing us more but also in eroding trust in our political and economic systems and preventing us from creating and expanding programs that would ensure more people get the food, shelter, and medical care they need. The announcement on Tuesday, and the breathless reporting about it, furthered that purpose. But the real story is in the White House, behind all the banners.
