The U.S. Department of Health and Human Services has found that nearly 3 million Americans were improperly enrolled in Medicaid or subsidized Affordable Care Act (ACA) insurance plans in 2024, resulting in billions in wasted taxpayer dollars.
According to a new analysis released by the Centers for Medicare and Medicaid Services (CMS), approximately 1.2 million people were enrolled in Medicaid or CHIP in multiple states, while another 1.6 million were simultaneously enrolled in both Medicaid and a subsidized ACA marketplace plan.
This duplicate coverage is projected to cost the federal government $14 billion annually, prompting sharp criticism and swift action from the Trump administration.
“HHS staff uncovered millions of Americans who were illegally or improperly enrolled in Medicaid and [Affordable Care Act] plans,” said HHS Secretary Robert F. Kennedy, Jr. “Under the Trump Administration, we will no longer tolerate waste, fraud, and abuse at the expense of our most vulnerable citizens.”
The agency says it reviewed historical enrollment data to identify discrepancies, a process that had been paused under the Biden administration during the COVID-19 public health emergency to prevent coverage loss. During that time, states were not required to check for duplicate enrollments.
Enrollment in ACA plans surged under President Biden, doubling from 12 million at the end of Trump’s first term in 2021 to 24 million in January 2025. Combined, an estimated 45 million Americans were covered under either ACA marketplace plans or Medicaid expansion for nondisabled adults without dependents as of this year.
CMS Administrator Dr. Mehmet Oz announced that states will now receive lists of individuals flagged for duplicate enrollments to verify eligibility and correct records. Similarly, state-based Obamacare marketplaces will be instructed to coordinate with Medicaid programs to eliminate overlap.
“We will work with states to fix the duplicate enrollment problem to save taxpayers billions of dollars, while minimizing inappropriate coverage loss,” Oz said.
Individuals who fail to correct their enrollment status within 30 days will have their premium subsidies revoked if they remain enrolled in both Medicaid and a subsidized ACA plan.
The findings support the GOP’s newly signed One Big Beautiful Bill Act, which introduces sweeping reforms to Medicaid and ACA operations. The bill is projected to reduce Medicaid spending by $1 trillion over the next decade and targets fraud through reforms like:
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Shortening the ACA open enrollment period
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Ending automatic re-enrollment
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Requiring income verification (no more self-attesting)
“This is exactly why we fought for stronger tools in the One Big Beautiful Bill Act — to go after this type of waste and finally put a stop to paying twice for the same person’s health coverage,” Oz added.
The Trump administration is positioning this effort as part of a broader strategy to restore fiscal responsibility and protect program integrity, while critics may raise concerns about the potential for coverage loss during the eligibility verification process.
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