Weeks before open enrollment begins, the federal government has removed hundreds of thousands of people from Affordable Care Act (ACA) marketplace plans in what officials describe as one of the largest anti-fraud actions in the program's history. On September 22, 2026, the Centers for Medicare & Medicaid Services (CMS) announced that it had canceled approximately 315,000 "unauthorized enrollments" in the federal marketplace, covering more than 760,000 individuals [1]. According to a CMS fact sheet, the cancellations took effect on August 31, 2026, after the agency confirmed that the enrollments were unauthorized [2]. CMS expects the action to return roughly $2.2 billion in taxpayer-funded premium subsidies [1].
What the government says happened
The action was led by the White House Task Force to Eliminate Fraud, which is chaired by Vice President JD Vance [1][6]. At a news conference, Vance and CMS Administrator Dr. Mehmet Oz tied the problem to the way insurance agents and brokers are paid. "You have a system where, on the one hand, brokers are paid money to feed patients into the system, while on the other hand, the government isn't even checking whether the people enrolled are actually eligible for the program," Vance said. "What do you have? Of course, rampant, rampant fraud" [6]. CMS described a three-part strategy: preventing improper enrollments up front, removing existing unauthorized enrollments and enforcing rules on agents and brokers [2]. The agency said applications submitted by some brokers lacked required documentation such as Social Security numbers [4]. Over the summer, CMS issued notices of intent to terminate to 569 agents and brokers, and about 200 had been removed from the marketplace as of the announcement [4]. Officials also said they had used AI-based detection tools to spot patterns of potential fraud rather than relying solely on case-by-case review [3]. Oz told reporters that much of the suspected misconduct involved newly registered agents and brokers, and the administration paused new agent and broker participation as part of the crackdown [5]. "Every dollar lost to fraud is a dollar taken from hardworking taxpayers and the Americans these programs are intended to serve," Oz said in the CMS announcement [1]. Health and Human Services Secretary Robert F. Kennedy Jr. said the agency is "pursuing bad actors, and holding agents and brokers accountable when they break the rules" [1].
More reviews to come
The cancellations may not be the last. Vance said the government would begin verifying lawful residency, Social Security numbers, income and other eligibility criteria for at least 419,000 additional enrollees [3]. According to HFMA, officials said they had found anomalies in that group but did not see as clear a fraud profile as in the group that had already been removed [3]. CMS also created a new anti-fraud coordination group within the agency and said it is working with state insurance regulators through the National Association of Insurance Commissioners to share data and enforcement practices [1][2].
The background: a broker problem with deep roots
Concerns about broker misconduct in the marketplace are not new. The federal marketplace allows licensed agents and brokers to enroll people directly, and they are typically paid commissions by insurers for each enrollment. Under the enhanced subsidies available from 2021 through 2025, many low-income enrollees qualified for plans with a $0 monthly premium. Investigators and journalists documented cases in which brokers signed people up for these plans, or switched them between plans, without their knowledge in order to collect commissions. The Biden administration also took enforcement action against agents and brokers in 2024, and Vance and Oz pointed to what they called "weakened guardrails" during the COVID-19 pandemic as a cause [8]. That history explains why it is difficult to say exactly who was affected. Reporting by HealthExec noted that it is "not entirely clear what, if any, fraud the individual beneficiaries engaged in" [4]. Some of the people removed may not have known they were enrolled at all. Others may have been real customers who wanted their coverage but were signed up through a broker whose paperwork was incomplete or improper.
Critics push back
Democrats sharply criticized the move. Former House Speaker Nancy Pelosi called it "the false pretext of fighting fraud to strip Americans of their healthcare," adding that it was "as cynical as it is cruel" [3]. Some health policy experts quoted in trade publications argued that rising premiums, not fraud, are the main problem facing the marketplace, and that fraud can be addressed without broad pauses that put coverage at risk [8]. Health Affairs Forefront, a leading health policy outlet, published two pieces examining the terminations in the days after the announcement, reflecting how quickly the action became a subject of debate among researchers [7]. Supporters of the crackdown counter that subsidies paid on behalf of people who never chose a plan are a direct cost to taxpayers and that the money returned to the Treasury, about $2.2 billion by CMS's estimate, is substantial [1].
What affected consumers can do
The timing matters because open enrollment for 2027 coverage begins November 1 [5]. According to legal guidance from FindLaw, people whose coverage was canceled should check their HealthCare.gov account and any notices from CMS or their insurer, and they should not assume they automatically qualify for a special enrollment period. FindLaw notes that a special enrollment period is not automatic when coverage is canceled for alleged fraud [5]. Anyone who believes they were removed in error can contact the marketplace call center, and anyone who has lost coverage can apply for a new plan during open enrollment.
Why it matters
The marketplace cancellations sit at the intersection of two major health policy debates in 2026: how to protect taxpayer money in subsidy programs and how to keep people insured as costs rise. More than 19 million people signed up for marketplace plans for 2026, about 13% fewer than in 2025, according to FindLaw's summary of enrollment data [5]. Whether the crackdown is remembered primarily as a successful fight against fraud or as a cause of coverage losses may depend on what the government's review of the next 419,000 enrollees finds, and on how many of the people already removed turn out to have been eligible all along.
Sources
- 1. "CMS Cracks Down on Fraud, Waste, and Abuse in the Federal Health Insurance Marketplace," Centers for Medicare & Medicaid Services press release, September 22, 2026. https://www.cms.gov/newsroom/press-r eleases/cms-cracks-down-fraud-waste-abuse-federal-health-insurance-marketplacer
- 2. "Federal Marketplace (FFE and SBE-FP) Anti-Fraud Actions," CMS fact sheet, September 22, 2026. https://www.cms.gov/newsroom/fact-sheets/federal-marketplace-ffe-sbe-fp-anti-fraud-actions
- 3. "CMS cites ACA marketplace enrollment fraud in issuing 760,000 coverage cancellations," HFMA, September 2026. https://www.hfma.org/payment-reimbursement-and-managed-care/aca-marketplace-enrollment-fraud/
- 4. "CMS kicks 760,000 people off ACA plans in crackdown on 'unauthorized' broker-supported enrollments," HealthExec, September 2026. https://healthexec.com/topics/healthcare-management/healthcare-policy/cm s-kicks-760000-people-aca-plans-crackdown-unauthorized-broker-supported-enrollments
- 5. Joseph Fawbush, "760,000 ACA Enrollees Were Dropped Over 'Fraud' Claims. Here's What Consumers Need to Know," FindLaw, 2026. https://www.findlaw.com/?p=215967
- 6. "Trump administration removes around 760,000 Obamacare enrollments, alleging fraud" (CNBC report as excerpted), GoLocalProv, September 23, 2026. https://www.golocalprov.com/news/big-news-stories-overnight-wednesday-september-23-2026
- 7. Health Affairs Forefront, "Administration Cancels Coverage For More Than 760,000, Blocks New Agents And Brokers" (October 1, 2026) and "The Troubling Termination Of 760,000 ACA Marketplace Members" (October 2, 2026). https://www.healthaffairs.org/forefront
- 8. "Trump administration cancels ACA coverage for 760,000, citing fraud," Healio, September 22, 2026. https: //www.healio.com/news/primary-care/20260922/trump-administration-cancels-aca-coverage-for-760000-cit ing-fraud Information in this article is current as of October 9, 2026. Bracketed numbers refer to the sources listed above.