Trump Admin Says It Uncovered $10 Billion Obamacare Fraud Scheme

Trump Admin Says It Uncovered $10 Billion Obamacare Fraud Scheme

According to a Department of Health and Human Services report obtained by Fox News Digital, officials have already removed nearly three million fraudulent or improper Obamacare enrollments and estimate another 2.6 million questionable enrollments remain.

Administration officials say the findings are part of a broader government-wide effort to eliminate fraud, waste and abuse across federal programs.

At the start of Biden’s presidency, approximately 10 million people were enrolled through the Affordable Care Act exchanges. By 2024, enrollment had surged to roughly 22 million.

The report traces the alleged problems to changes made during the Biden administration that expanded enrollment opportunities while relaxing income verification and eligibility checks

Federal investigators now believe millions of those enrollments were improper, fraudulent or created without the knowledge of the individuals involved.

“We estimate 2.6 million improper and phantom enrollments remain, including over 1 million enrollments without a social security number.”

According to the report, several different forms of abuse contributed to the alleged fraud.

“By our estimate, improper, phantom, and fraudulent enrollment peaked at 5.6 million people in 2025,” the report states

Others allegedly received premium assistance despite failing to meet eligibility requirements.

Investigators also identified what they describe as “phantom enrollments,” in which insurance brokers allegedly enrolled people in Obamacare plans without their knowledge in order to collect federal commissions.

Since taking office, the Trump administration says it has restored stricter income verification requirements, ended several special enrollment periods, increased screening for duplicate Medicaid enrollment and launched investigations into brokers suspected of creating phantom policies.

Officials say some applicants intentionally understated their income to qualify for larger taxpayer-funded subsidies

Officials also say they have strengthened oversight of agents participating in the federal marketplace.

Even after those removals, approximately 19.2 million people remain enrolled.

The administration says its goal is not to reduce legitimate coverage but to ensure taxpayer dollars are being spent only on individuals who actually qualify.

The report argues that reduced verification requirements made those practices significantly easier to carry out

“The federal government paying brokers to enroll individuals without their knowledge is not.”

The report also says the administration will continue pursuing additional enforcement actions against brokers and others accused of exploiting the program.

The findings are likely to reignite debate over the Affordable Care Act and how aggressively eligibility rules should be enforced.

As a result of those efforts, nearly three million enrollments have already been removed from the Affordable Care Act exchanges

Critics of previous verification rollbacks have long warned that loosening enrollment safeguards could increase improper payments and fraud, while supporters of the Biden-era policies argued the changes made healthcare more accessible to eligible Americans, Fox News reported exclusively.

The administration says its investigations remain ongoing, with an estimated 2.6 million additional enrollments still under review as officials continue auditing the federal health insurance exchanges.

 

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