Obamacare Enrollment Declines Driven by Subsidy Cuts, Not Removing Fraudulent Enrollees

Millions of low- and middle-income Americans are losing health coverage because the Trump administration allowed the subsidies that made it affordable to lapse, according to a new Public Citizen analysis of government data. The analysis contradicts claims by Trump administration health officials that removal of fraudulent enrollees is responsible for declining Obamacare enrollment.

Enrollment in the Affordable Care Act marketplace decreased from 22.3 million people in 2025 to an estimated 17.5 million in 2026. Administration officials, including Health and Human Services Secretary Robert F. Kennedy Jr. and Centers for Medicare and Medicaid Services Administrator Mehmet Oz, have attributed the decline to the removal of fraudulent enrollees. Public Citizen’s analysis, which uses the government’s own enrollment data, has found that explanation to be almost entirely wrong.

“The people losing coverage are concentrated at incomes well above the poverty line – exactly the opposite of what the administration’s fraud theory would predict,” said Peter Whoriskey, Health Research Group research director for Public Citizen and author of the report. “These are low- and middle-income families whose premiums doubled after subsidies were cut. They didn’t cheat their way in. They simply can’t afford to stay.”

The administration’s fraud theory – which originated with the Paragon Health Institute, a think tank aligned with the Trump administration – holds that millions of enrollees misreported income just above the federal poverty level to qualify for subsidies. If the theory were correct, the sharpest enrollment declines would appear at that income level.

Instead, enrollment in that bracket has grown. Nearly half of all enrollment losses are among people earning more than four times the poverty level – families whose subsidies were cut when congressional Republicans allowed the enhanced premium tax credits to expire.