Here’s what happened.
The Trump administration is stepping up its effort to strengthen oversight of the Affordable Care Act, launching a new crackdown on insurance agents accused of improperly enrolling people in Obamacare plans.
The Centers for Medicare & Medicaid Services (CMS), led by Administrator Dr. Mehmet Oz, said it has issued notices of intent to 100 Affordable Care Act marketplace agents accused of repeatedly submitting health insurance applications that lacked Social Security numbers or other required identifying information, actions the agency says violated federal enrollment rules.
Marketplace agents help Americans compare and enroll in health insurance plans through the Affordable Care Act exchange. However, federal officials say some agents may have bypassed important verification requirements, raising concerns that taxpayer-funded subsidies were awarded to individuals who were not properly eligible.
According to CMS, roughly 35% of Marketplace enrollments may be illegitimate. If those estimates are accurate, between 5 million and 6 million enrollments could have received federal premium assistance that should not have been approved, potentially costing taxpayers billions of dollars.
The latest action comes after a Department of Health and Human Services review found an estimated 2.6 million questionable or “phantom” enrollments still active in the Affordable Care Act marketplace. The report also found that more than 1 million applications were filed without a Social Security number, a finding officials say points to significant gaps in the program’s identity verification and enrollment safeguards.
The Trump administration says these findings demonstrate why additional safeguards are necessary to protect both taxpayers and patients. In response, CMS has proposed several reforms designed to strengthen eligibility verification, improve oversight, reduce waste, and limit improper government spending.
Agency officials estimate those reforms could have saved taxpayers approximately $3 billion. CMS also argued that several of the proposed anti-fraud measures were never fully implemented after facing opposition in Congress.
The latest action is part of a broader effort by the Trump administration to increase accountability across federal healthcare programs.
Earlier this year, Dr. Oz sent letters to officials in California, Florida, Minnesota, New York, and Maine regarding possible fraud involving medical equipment suppliers. At the same time, a federal anti-fraud task force led by Vice President JD Vance announced a nationwide effort to closely examine suppliers of durable medical equipment, prosthetics, orthotics, and related medical products.
Federal investigators later released data showing Medicare claims for skin substitute products increased by more than 7,100% between 2019 and 2025, climbing from approximately $200 million to $14.4 billion. The dramatic increase prompted CMS and the task force to conduct a nationwide review of billing practices.
Since March, CMS says it has denied 96% of skin substitute claims submitted during its review after identifying widespread irregularities. Through May, investigators had flagged approximately 4,200 questionable claims totaling $224 million in charges.
Trump administration officials say these enforcement efforts reflect a broader commitment to protecting Medicare, safeguarding taxpayer dollars, and improving public confidence in federal healthcare programs. Supporters argue that stronger oversight is essential to ensuring healthcare benefits reach eligible Americans while reducing waste and abuse throughout the system.
