WASHINGTON — The Centers for Medicare & Medicaid Services said Wednesday that it has stopped, or is stopping, Affordable Care Act subsidies for about 189,000 Marketplace enrollments in 2026 after data checks showed the enrollees also had Medicare, Medicaid or Children’s Health Insurance Program coverage, or were recorded as deceased.
CMS estimates the actions will prevent about $738 million in subsidy payments in 2026, and about $1.5 billion over a full year. The figures are agency estimates of payments avoided — not money recovered — and officials stressed that a data match is not by itself a finding of fraud.
People whose issue is duplicate coverage do not lose health insurance altogether: their Medicare, Medicaid or CHIP coverage continues. What ends is the second, subsidized Marketplace policy.
How the 189,000 breaks down
According to CMS officials speaking at a Wednesday briefing, as reported by Reuters:
- About 120,000 of the enrollments also showed Medicaid coverage — the largest share.
- About 58,000 also showed Medicare coverage, down from 93,000 cases in 2024, CMS official Peter Nelson said.
- About 11,000 were records of enrollees listed as deceased through July, with about 3,500 more expected to be removed by the end of October.
“Taxpayers should not foot the bill for duplicate coverage or subsidies for people who have died,” HHS Secretary Robert F. Kennedy Jr. said.
Second year of restored checks
Federal regulations require exchanges to run periodic data matching to catch dual enrollment in Medicaid and CHIP. CMS says those checks were paused during the Biden administration and restored in 2025, when the agency ended duplicate subsidies for about 551,000 enrollees who already had Medicaid. CMS Administrator Dr. Mehmet Oz said the wider effort has saved nearly $6 billion — an agency figure that includes earlier actions.
What happens if you receive a notice
- CMS contacts flagged enrollees — or their estate, in deceased-record cases — and gives them 30 days to dispute the match.
- If the match is not resolved, the Marketplace subsidy ends; for deceased-enrollee records, the plan ends as well.
- Even after the 30 days, enrollees may appeal the determination, or show that their Medicaid or CHIP coverage is about to lapse and regain Marketplace subsidies.
- Records can be wrong or out of date. Nelson said that in the first Medicaid review round this summer, about half of those flagged resolved the match by the deadline, and no one lost all coverage, because everyone affected was covered by another program or was deceased.
Consumers can check their enrollment status through HealthCare.gov or through their Medicare or Medicaid program.
Sources
Centers for Medicare & Medicaid Services, “Trump Administration Delivers Second Year of Savings by Stopping Taxpayer Payments for Duplicate and Deceased Enrollees” (Oct. 14, 2026); Reuters reporting of the Oct. 14 CMS briefing.
