After cutting 760,000 from ACA plans over fraud, Trump administration reinstates some as Florida braces for open enrollment

The Trump administration has begun quietly reinstating some Affordable Care Act enrollees it cut off in September over alleged fraud, after people who say they were legitimately covered turned up among the roughly 760,000 removed. The reversals matter most in Florida, which has more people in HealthCare.gov marketplace plans than any other state, and they come two weeks before open enrollment for 2027 coverage begins on Nov. 1.

Insurance industry sources told KFF Health News that the Centers for Medicare & Medicaid Services (CMS) has restored coverage for a small number of people whose plans should not have been canceled, and more reinstatements could follow as enrollees discover they are uninsured when they try to use their insurance. CMS has not said how many cancellations it has reversed.

What the administration did

On Sept. 22, Vice President JD Vance, who leads a White House task force on fraud, announced the cancellation of about 315,000 marketplace enrollments covering roughly 760,000 people. He said the move would save $2.2 billion in subsidy payments and that another 419,000 enrollments would undergo additional verification. Officials alleged that the people removed were fraudulently enrolled or did not exist, according to The Associated Press.

"We're actually making sure that the people receiving Obamacare subsidies are actually entitled to receive them," Vance said at the announcement, where he was joined by CMS Administrator Dr. Mehmet Oz. The administration also announced a six-month suspension on new agents and brokers signing up enrollees, saying brokers were responsible for a disproportionate share of the fraud it found.

The cancellations apply only in states that use HealthCare.gov, the federal marketplace. Florida is one of them. The 21 states that fully run their own marketplaces were not affected.

How enrollees were flagged

According to information CMS provided to KFF Health News, the agency in June selected nearly 1.2 million enrollments for review that had all four of what it considered warning signs of fraud:

• The application included no Social Security number or immigration document number.
• A broker was involved in the sign-up.
• The plan had no monthly premium payment.
• The enrollee had no contact with the insurer and no claims filed.

CMS then sent lists of those accounts to insurers and told them to try at least two ways of reaching each enrollee, such as a phone call and a letter. Policyholders had 30 days to respond and supply the missing information. CMS disenrolled those who did not.

Critics say that process could catch real customers. Many healthy people go a year without filing a claim, and many people ignore calls from unknown numbers or unopened mail. "There will be legitimate people who don't have a claim or don't respond to an inquiry from an insurer," Matthew Fiedler, a senior fellow at the Brookings Institution, told KFF Health News.

Supporters of the crackdown, including Brian Blase of the Paragon Health Institute, argue that the canceled accounts were overwhelmingly "phantom" enrollees signed up for zero-premium plans by rogue call centers without their knowledge. Blase and administration officials say anyone wrongly removed only needs to call the marketplace and provide a Social Security number or other missing information.

The reinstatements

David Merritt, senior vice president of external affairs at the Blue Cross Blue Shield Association, confirmed that some Blue Cross Blue Shield members are among those reinstated and said CMS has an expedited review process for people who find they were improperly disenrolled. He did not say which plans those members belong to. Florida Blue is the Blue Cross Blue Shield company in Florida.

Beyond that, the administration has released few details. CMS has not disclosed how robust the outreach was, how long reinstatement takes or how many people have been restored. "Currently, there is no additional data to share," the agency's press office told KFF Health News.

"It may be true that some of those enrollments were not authorized, but it can be equally true that people got lost in the shuffle and have a valid enrollment," said Katie Keith, a director of the Center for Health Policy and the Law at Georgetown Law.

Oscar Health, one of the insurers selling marketplace plans in Florida, estimated in a Securities and Exchange Commission filing that 250,000 to 300,000 of its members nationwide might be disenrolled because of the CMS effort. CEO Mark Bertolini told investors in August that the company had made contact with some people on the CMS list.

Why Florida is exposed

No state relies on the federal marketplace more than Florida. According to CMS data reported by the Florida Phoenix and WLRN, 4,474,300 Floridians selected 2026 plans through HealthCare.gov during open enrollment, the most of any state and ahead of Texas at about 4.1 million. KFF research cited by WFSU found that about 97% of Florida marketplace customers used federal premium tax credits.

Enrollment was already falling before the fraud sweep. Enhanced subsidies expired at the end of 2025, and Florida's effectuated enrollment, people who signed up and paid their first premium, fell about 10%, from 4.3 million to 3.85 million, in early 2026, according to KFF data analyzed in a piece republished by WLRN. That was the largest drop in raw numbers of any state.

KFF Health News reported that many of the people removed are likely in states such as Texas, Florida, Louisiana and Mississippi, where marketplace enrollment grew quickly between 2020 and 2025. CMS has not released a state-by-state breakdown of the 760,000 cancellations, so it is not known how many Floridians lost coverage or have been reinstated.

The second phase

The review is not over. Insurers are now contacting the additional 419,000 enrollees flagged for verification of legal residency, Social Security numbers and income. Insurers must tell CMS how many of those enrollees fail to respond by "around mid-to-late November, after the midterm elections," Merritt said.

Separately, at an Oct. 14 news conference, Health and Human Services Secretary Robert F. Kennedy Jr. and Oz highlighted the removal this year of subsidies for about 189,000 marketplace enrollees who also had Medicare, Medicaid or Children's Health Insurance Program coverage, which they attributed to more frequent data matching, not fraud.

What Floridians should do

Anyone who believes their plan was canceled in error should contact HealthCare.gov or their insurer, and be ready to supply a Social Security number or immigration document number. Free help is available from the Covering Florida Navigator Program at coveringflorida.org or 877-813-9115.

Enrollees should also open mail and answer calls from their insurer in the coming weeks, since insurers are again reaching out to people in the second review group.

What's next

Open enrollment for 2027 coverage on HealthCare.gov begins Nov. 1. Under current federal guidance, it runs through Jan. 15, 2027, after a federal court blocked a rule that would have shortened the window; the administration has appealed. Floridians who want coverage to start Jan. 1 must enroll by Dec. 15.

Because of the broker suspension, agents and brokers without an active 2026 marketplace registration cannot register to enroll clients for 2027, so Floridians who use an agent should confirm that theirs is still registered. Insurers' reports on the second-phase review are due to CMS after the Nov. 3 election.