RFK Jr., Oz blame ACA enrollment drop on fraud, but experts cite rising costs
Rising premiums forced many people in Affordable Care Act plans to give up their coverage. But the Trump administration claims a huge drop in enrollment is almost entirely due to its fraud crackdown.
RFK Jr. and Oz blame ACA enrollment drop on fraud, but experts say rising costs are the primary cause, according to <source>. Enrollment fell by nearly 3 million this year to 19.2 million, following steep premium increases and a Republican-led Congress' unwillingness to extend premium subsidies, <source>. ACA customers pay $178 a month, a 58% increase from 2025, while deductibles have climbed 37% to nearly $3,800, <source>.
HHS reported 5.6 million fraudulent ACA enrollments in 2025, of which 2.9 million were removed, matching the 2026 enrollment drop, <prosecutors>. However, health policy experts dispute the administration's assertion and claim the report relies on debatable assumptions, <source>. The administration halted a Biden-era program that allowed low-income people to sign up year-round and removed 1.5 million for reasons like not filing taxes, according to <source>.
The drop in enrollment is primarily due to escalating insurance prices, not fraud, say health experts, <senior fellow> and <professor>. ACA coverage doubled from 11 million in 2021 to 22 million in 2025 due to tax subsidies and higher assistance for wealthier households, <professor>. Republicans argue the enrollment growth was fueled by fraud, but experts say subsidies remain generous, <conservative groups>.
The debate continues as enrollment data emerges, with the HHS report anticipating a 26% drop in ACA policyholders by year-end, <HHS Secretary>.
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