The Trump administration cancelled enrollment in the Affordable Care Act healthcare program for about 750,000 people due to ineligibility suspicions, Vice President JD Vance said Tuesday.
The individuals are connected to more than $2.2 billion in fraudulent Obamacare payments, Vance alleges, or about 2% of the Affordable Care Act’s annual $112 billion budget. Vance touted the announcement as an effort to ensure that elderly Americans and children who rely on Obamacare get the services they need.
“These programs, they’re deserving, they’re important, but they’re not going to exist unless we stop the fraud,” Vance said.
Vance said fraud in Obamacare allowed insurance brokers and ineligible individuals to collude and obtain funds.
“We had a system in this country that rewarded brokers, that made people rich for enrolling fake people in programs that are meant to ensure our fellow citizens have healthcare,” Vance said.
Mehmet Oz, administrator of the Centers for Medicare and Medicaid Services, said Obamacare was meant to serve as a program that helped bring individuals out of poverty. He said Obamacare is structured in a way that prevents law enforcement from assessing fraud damages.
He estimated enrollment in the ACA went from 10 million to 22 million during the COVID-19 pandemic as eligibility restrictions were eased. Oz argued that some of the increase could be attributed to fraud.
“We know there is fraud,” Oz said. “It’s an open secret that you can come into the federal government and use this as a piggybank.”
Oz announced that CMS will hold a six-month moratorium on Obamacare broker enrollments.
CMS will also require all existing agents and brokers in the Obamacare program to re-identify proof of eligibility through a federal database. Future applications will also require individuals to provide a Social Security number or immigration documents to enroll.
The federal healthcare agency is also taking steps to prevent brokers from being assigned to provide care when it is not necessary. CMS is barring brokers from being assigned to cases that individuals may fill out on their own and requiring electronic consumer authorization before an agent can act on consumer’s application.
“CMS is strengthening safeguards, pursuing bad actors, and holding agents and brokers accountable when they break the rules. Under President Trump, HHS will protect Americans’ health coverage and ensure taxpayer dollars reach the people they are intended to serve,” said HHS Secretary Robert F. Kennedy Jr.
Andrew Ferguson, chairman of the Federal Trade Commission, said the Biden administration intentionally overlooked program integrity requirements during the COVID-19 pandemic, which allowed fraud to continue unchecked.
“We have a social trust problem in this country but that was a choice,” Ferguson said. “We have rules and laws that are designed to backstop social trust in this country and it was a choice that we all lived under for four years with an administration that just refused to enforce them.”
Vance called on Democratic members of Congress to join the Trump administration in pursuing fraud. He said the only way to protect social welfare programs is to pursue fraud.
