The federal government has cut off Affordable Care Act subsidies for about 189,000 people in 2026 after determining they had duplicate government health coverage or were deceased, according to an administration statement. The action, detailed in a Reuters report out of Washington, D.C., breaks down into roughly 120,000 cases involving overlapping Medicaid coverage, about 58,000 involving duplicate Medicare coverage, and nearly 11,000 tied to enrollees flagged as deceased.
According to Reuters, the Centers for Medicare & Medicaid Services identified 2026 federal marketplace enrollees who were also enrolled in Medicare, Medicaid or CHIP, along with deceased individuals still appearing on ACA subsidy rolls. U.S. Health Secretary Robert F. Kennedy Jr. said CMS identified the duplicate coverage and deceased enrollees this year, framing the effort around a basic principle: the government, he said, cannot continue paying subsidies for people who have died, and must check whether HealthCare.gov subsidies are actually owed. The administration estimates the move will prevent $738 million in improper subsidy payments this year, with HHS projecting annualized savings of about $1.5 billion, Becker's Hospital Review reports.
How the Numbers Break Down
Of the roughly 11,000 deceased-enrollee cases confirmed through July, CMS expects to remove another 3,500 by the end of October, per the same Becker's account. The administration also expects to prevent more than 1 million months of improperly subsidized coverage by year's end. The scale marks a shift from prior enforcement: duplicate Medicaid-ACA cases are down from about 551,000 in 2025, though still well above the historical baseline of roughly 55,000, while duplicate Medicare cases have fallen from 93,000 in 2024 to about 58,000 this year, the outlet notes.
CMS Medicaid Director Dan Brillman said the agency has been finding about 1.2 million people a month who appear enrolled in Medicaid or CHIP in more than one state at once — a volume that helps explain why the duplicate-coverage sweep keeps surfacing new cases even as the numbers trend downward from last year's peak. Brillman also said states must begin verifying enrollee addresses starting in January 2027, a step aimed at catching overlapping coverage earlier.
September's Fraud Purge
CMS official Peter Nelson said flagged enrollees, or their estates, get 30 days to contest a finding before subsidies actually stop. Nelson said that in the first round of Medicaid-related cuts, half of affected enrollees resolved the coverage match before the deadline, and he said no one in that first round ultimately lost coverage, since those affected were either covered elsewhere or had died.
In September, Vice President JD Vance said the administration was halting enrollment for more than 760,000 people believed to have fraudulently signed up for Obamacare coverage, estimating that move would save $2.2 billion. That earlier action canceled roughly 315,000 marketplace enrollments covering 760,000 people, according to HFMA. The administration has separately said it planned to review 419,000 additional enrollees.
Enrollment Already Sliding
The broader marketplace has been shrinking even before this week's cuts. ACA marketplace enrollment stood at 19.2 million in February, down 2.9 million from a year earlier, according to the HFMA report. That decline follows the expiration of enhanced subsidies that had been in place from 2021 through 2025, a policy shift that made coverage more expensive for many enrollees even before the duplicate-coverage and fraud reviews began trimming rolls further.
Together, the administration describes the duplicate-coverage and deceased-enrollee findings as part of a continued, broader crackdown against alleged fraud in the ACA marketplace.
