Health and Human Services (HHS) Secretary Robert F. Kennedy Jr. and Centers for Medicare & Medicaid Services (CMS) Administrator Dr. Mehmet Oz said more than 1 million Affordable Care Act marketplace enrollees do not have Social Security numbers linked to their coverage, a discovery officials said has prompted closer scrutiny of enrollment integrity across the federal exchange.
The officials announced the finding in a video released Saturday, saying efforts are underway to remove improper enrollments and recover taxpayer funds.
An HHS review of Affordable Care Act enrollment identified millions of improper, phantom, and fraudulent marketplace enrollments, with agency estimates placing the total at about 5.6 million in 2025.
The department said fraudulent activity has contributed to roughly $10 billion in annual taxpayer costs between 2021 and 2024.
Officials said nearly 3 million questionable enrollments have already been removed, with millions more expected to be reviewed.
Kennedy said the findings reflect what he described as weakened oversight measures under the previous administration.
“The Obamacare marketplace is plagued by fraud in large part because the Biden administration dismantled basic program integrity guardrails, while partisan lawfare blocked common sense efforts to protect taxpayers,” he said, according to American Almanac.
He also questioned the legitimacy of payments tied to incomplete identity records, asking, “Why are we paying people we don’t know if they actually exist?”
Oz described what investigators believe are multiple schemes involving marketplace enrollments submitted without consumer knowledge.
He said some insurance agents allegedly used stolen personal data or created fabricated identities to enroll individuals in coverage that required no monthly premium, allowing commissions to be paid while individuals remained unaware policies had been issued in their names.
Oz said many of these applications were missing Social Security numbers, calling it “a huge red flag.”
Administration officials said new safeguards introduced in May now require agents to submit government-verified information before commissions can be issued for marketplace enrollments.
Kennedy said HHS is working with insurers to cancel policies deemed improper and recover taxpayer funds tied to those enrollments.
CMS officials added that enforcement efforts will continue as additional marketplace enrollments undergo review ahead of the next open enrollment period.
The administration has not identified specific insurance agents, brokerages, or companies allegedly involved in the reported activity.
Officials also have not detailed how investigators identified more than 1 million enrollments lacking Social Security numbers or provided a full accounting of recovered funds.
HHS said only that thousands of fraudulent policies have been eliminated so far as the broader review continues.
The announcement comes as the Trump administration expands fraud enforcement across federal health programs.
According to Townhall, Congressional Budget Office projections estimate that Medicare, Medicaid, premium tax credits, and the Children’s Health Insurance Program will cost more than $1.9 trillion in fiscal year 2026.
Officials said the review is part of a broader effort to tighten oversight across federal health insurance programs as enrollment data continues to be audited.
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