Trump Admin Says It Uncovered $10 Billion Obamacare Fraud Scheme

The Trump administration says it has uncovered what officials describe as a sweeping fraud and improper-enrollment problem inside the Affordable Care Act exchanges, with roughly $10 billion in taxpayer money allegedly paid out between 2021 and 2024.

A new Department of Health and Human Services report says federal officials have already removed nearly three million fraudulent, improper, or otherwise questionable Obamacare enrollments and believe another 2.6 million remain under review.

Administration officials say the problems accelerated under former President Joe Biden after enrollment rules were loosened, verification requirements were reduced, and additional pathways into the federal exchanges were created.

When Biden entered office, roughly 10 million people were enrolled through ACA exchanges. By 2024, that figure had climbed to approximately 22 million.

Federal investigators now believe a significant share of that increase included improper, fraudulent, or so-called phantom enrollments.

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

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

The report describes several alleged methods used to exploit the system.

Some applicants are accused of understating their income in order to qualify for larger federal subsidies.

Others allegedly received taxpayer-funded premium assistance despite not meeting eligibility requirements.

Investigators also identified what the administration calls “phantom enrollments,” in which insurance brokers allegedly enrolled people in ACA plans without their knowledge in order to collect federal commissions.

According to the report, weaker verification procedures made those abuses easier to carry out and harder to detect.

Since returning to office, President Donald Trump’s administration says it has moved to tighten eligibility checks and restore stronger program safeguards.

Those changes include stricter income verification, the elimination of certain special enrollment periods, more screening for duplicate Medicaid coverage, greater oversight of marketplace agents, and investigations into brokers suspected of enrolling people without authorization.

Officials say those efforts have already resulted in nearly three million enrollments being removed from ACA exchanges.

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

The administration says the objective is not to strip coverage from eligible Americans, but to ensure taxpayer-funded subsidies are going only to people who actually qualify.

“Preserving the fiscal and programmatic integrity of the ACA Exchanges is key to safeguarding taxpayer-funded resources for those that truly need them,” the report states.

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

HHS also says additional enforcement actions are expected as investigators continue examining brokers and other participants accused of manipulating the system.

“The Trump Administration continues to aggressively root out fraud, waste, abuse, and corruption by promulgating new regulations to improve program integrity, investigating suspected improper or fraudulent enrollment, and taking action against agents and brokers committing fraud.”

The findings are likely to reopen a long-running political battle over Obamacare, federal subsidies, and how aggressively the government should verify eligibility before approving taxpayer-funded health benefits.

Supporters of the Trump administration argue the report shows why tighter controls are necessary, particularly when billions of dollars in federal spending are at stake.

Defenders of Biden-era enrollment policies have argued that expanded access and reduced administrative barriers helped more eligible Americans obtain health insurance.

But critics have long warned that weaker safeguards could also create opportunities for improper payments, duplicate enrollment, and outright fraud.

Fox News reported exclusively on the administration’s findings.

The investigation is not finished.

According to the administration, another 2.6 million enrollments remain under scrutiny as federal officials continue reviewing records across the exchanges.

The findings could also strengthen Republican calls for broader changes to the Affordable Care Act.

Trump has pushed for years to replace or significantly overhaul Obamacare, and a multibillion-dollar fraud controversy could give Republicans fresh political momentum to revisit the law.