WASHINGTON — The federal government is ending Affordable Care Act premium subsidies tied to approximately 189,000 enrollment records that also show Medicare, Medicaid or Children’s Health Insurance Program coverage—or identify the enrollee as deceased.
The Centers for Medicare & Medicaid Services announced the action Wednesday, Oct. 14, saying the reviews could prevent about $738 million in subsidy payments during 2026 and roughly $1.5 billion over a full year. The affected plans are offered through the federal ACA marketplace, commonly known as Obamacare.
According to Reuters, CMS identified about 120,000 people whose records also showed Medicaid coverage, 58,000 who also had Medicare and roughly 11,000 records linked to people reported as deceased through July.
The agency said people flagged for duplicate coverage—or their estates when death records are involved—receive notice and have 30 days to dispute the match. If the record is not corrected, CMS stops the marketplace subsidy and may cancel the associated plan.
For consumers with valid Medicare or Medicaid coverage, the action does not eliminate that other insurance. CMS official Peter Nelson told reporters that nobody in the first Medicaid review round lost all health coverage because those affected either remained covered through another government program or were deceased.
The distinction matters for families who receive a notice. A data match does not necessarily prove intentional fraud, and records can be outdated or incorrect. Consumers who believe they have been flagged by mistake should respond within the stated deadline and verify their enrollment through official Medicare, Medicaid or HealthCare.gov channels.
CMS Administrator Mehmet Oz said Wednesday’s review is separate from an enforcement action announced in September involving more than 760,000 people whose marketplace enrollments the administration said were unauthorized. That earlier action was projected to save $2.2 billion.
Federal regulations require ACA exchanges to compare enrollment data periodically so people do not receive marketplace tax credits while also enrolled in Medicaid or CHIP. CMS said it also checks Medicare and federal death records and gives affected consumers a chance to contest a mismatch before assistance ends.
The announcement comes as ACA enrollment has fallen and many households face higher insurance costs. A separate Reuters report Wednesday cited KFF data showing enrollment dropped to 20.5 million in June, down 18% from 25.2 million a year earlier, after enhanced pandemic-era subsidies expired and premiums rose for many consumers.
People who receive an eligibility notice should use contact information listed on the official notice or visit HealthCare.gov directly rather than responding to unsolicited calls, emails or payment requests.
