A federal review of health insurance records has turned up a group of enrollees who should not have been receiving help paying their premiums, including some who had already died. The findings come as the administration expands efforts to root out what it calls improper and fraudulent signups.
Federal health officials said Oct. 14, 2026, that 189,000 people were improperly enrolled in subsidized Affordable Care Act coverage while also enrolled in another government insurance program or after their deaths.
What did the Affordable Care Act review find?
Officials with the Department of Health and Human Services and the Centers for Medicare and Medicaid Services compared marketplace enrollment with death records and other government data.
They found people who were receiving subsidized marketplace plans while also covered by programs such as Medicare. They also found subsidized plans still active for people who had died. It was not immediately clear how many cases involved intentional fraud rather than paperwork or timing errors.
The health secretary said officials would follow the evidence, fix mistakes and pursue fraud wherever they find it.
How many people have been removed?
So far this year, officials have removed about 58,000 people from marketplace coverage because they already had Medicare, according to a CMS official. Another 11,000 subsidized plans were ended for people who had died, the official said.
Officials estimate the removals will prevent about $738 million in improper subsidy payments this year. Subsidies, formally known as premium tax credits, are paid directly to insurers to lower monthly premiums for eligible enrollees.
Most people who receive Medicare are not eligible for marketplace subsidies, which is why holding both is considered improper.
What happens to people flagged in the Affordable Care Act review?
They get a chance to respond. People flagged as enrolled in both Affordable Care Act coverage and a program like Medicare are notified and given 30 days to provide evidence that resolves the issue.
When records show an enrollee has died, the person’s estate also receives 30 days to respond. Plans can stay active after a death when no one notifies the marketplace, a gap that matching records is meant to close.
Coverage is ended only after that process is complete. Anyone who believes they were flagged in error should respond within the window and keep records of their coverage.
Why are officials focused on improper enrollments?
The review is part of a broader push by the administration to tighten Affordable Care Act enrollment.
In September, the government announced it had canceled about 315,000 marketplace enrollments covering more than 760,000 people, saying reviews with insurers confirmed those signups were unauthorized. Officials said roughly 419,000 more enrollees would face additional verification.
Officials have blamed some problems on insurance agents and brokers who enrolled people without their consent or submitted inaccurate information to collect commissions. The government has sent termination notices to hundreds of brokers this year.
Supporters of the effort say it protects taxpayers. Critics of past crackdowns have warned that data mismatches and paperwork hurdles can cause eligible people to lose coverage, which is why the response window matters.
How many people use Affordable Care Act coverage?
About 19.2 million Americans were enrolled in Affordable Care Act marketplace plans as of February, according to a federal report released in June. Enrollment grew sharply after Congress expanded subsidies during the pandemic.
The cases flagged in this review represent about 1% of that total.
With open enrollment for 2027 coverage approaching, officials say they will keep checking records. For people who rely on the Affordable Care Act, keeping their information up to date may help avoid surprises.
