health

CMS reinstates some ACA enrollees cut in fraud review, reviews 419,000 more

• The Centers for Medicare & Medicaid Services has reinstated a small number of the 760,000 Americans dropped from Affordable Care Act coverage in the Trump administration's anti-fraud effort, with insurance industry sources telling KFF Health News more reversals could follow if enrollees discover they are uninsured when they go to use their coverage.
• CMS is reviewing an additional 419,000 ACA sign-ups in a second phase, with insurers required to report on outreach by mid-to-late November, after the midterm elections.
• Unauthorized ACA sign-ups by rogue insurance agents seeking commissions and other potential impropriety have been a concern for several years, with much debate over the magnitude of the problem.
• Brian Blase of the Paragon Health Institute, whose findings have sometimes been characterized as controversial, said "This was clearly phantom enrollees," estimating more than 99% of cancellations were zero-premium sign-ups by rogue call centers or for people who do not exist.
• HHS Secretary Robert F. Kennedy Jr. and CMS Administrator Mehmet Oz on Oct. 14 also announced the removal of subsidies for about 189,000 ACA enrollees with duplicate Medicare, Medicaid, or CHIP coverage.
• Polls show healthcare costs tied with gas prices as a top voter concern, and the political impact remains uncertain; the cancellations target only states using Healthcare.gov and likely fall heavily on red states such as Texas, Florida, Louisiana, and Mississippi, where enrollment grew from 2020 to 2025 before Biden-era enhanced subsidies expired.