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News|Articles|October 15, 2026
ACA Subsidies End for 189,000 Duplicate or Deceased Enrollees
Author(s)Giuliana Grossi
Fact checked by: Ashley Gallagher, MA
CMS ends ACA subsidies for 189,000 enrollees with duplicate Medicare, Medicaid, or CHIP coverage or listed as deceased, with a 30-day dispute window.
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Affordable Care Act (ACA) subsidies have been ended for about 189,000 Federal Marketplace enrollees in 2026 who also had Medicare, Medicaid, or Children's Health Insurance Program (CHIP) coverage or were listed as deceased, according to HHS.1
“Taxpayers should not foot the bill for duplicate coverage or subsidies for people who have died,” HHS Secretary Robert F. Kennedy Jr. said in the
How Many Enrollees Were Affected?
HHS did not break down the 189,000 total in its release. At a news conference, CMS Administrator Mehmet Oz, MD, said about 120,000 of the enrollees had Medicaid overlap, down from about 551,000 enrollees in 2025 but still above a historical level of roughly 55,000 dual Medicaid-ACA enrollees.2,3 Peter Nelson, who oversees the ACA marketplace, reported about 58,000 enrollees with Medicare overlap, down from 93,000 in 2024. Roughly 11,000 were enrollees listed as deceased through July, and CMS expects to remove subsidies for another 3500 by the end of October.
People whose records show subsidized marketplace coverage alongside Medicaid or Medicare are contacted and have 30 days to dispute the finding or cancel the duplicate coverage, and CMS ends their marketplace subsidies if they do not respond.1,2 After 30 days, enrollees may still appeal or show that their Medicaid or CHIP coverage is about to lapse and regain subsidies.1 For enrollees listed as deceased, CMS contacts the individual or their estate and allows 30 days to dispute the record.
Oz said enrollees who do not respond default to Medicaid, and that no one is losing health insurance coverage as a result of the action.2,3 The release says only that CMS ends subsidies for the marketplace plans of people who do not respond.1 Nelson added that about half of the people notified in the first Medicaid round resolved the match before the deadline and that no one lost coverage.2
Projected Savings From the Subsidy Cuts
HHS said the crackdown has the potential to save approximately $1.5 billion over the next year.1 Kennedy said at the news conference that CMS estimates the 2026 work will prevent $738 million in improper subsidy payments this year.2,3 The release does not say how the two estimates relate. It quotes Oz saying the agency has already saved nearly $6 billion, without specifying which efforts that total includes.1
CMS Medicaid Director Dan Brillman said the agency found about 1.2 million people a month who appeared to be enrolled in Medicaid or CHIP in more than one state.2 A CMS analysis of 2024 data, released in July 2025, found the same monthly average.4
Brillman also said CMS is building a national system that states will use to check enrollment monthly.2 Becker's separately reported that, starting in January, states will be required to regularly obtain and verify enrollee address information.2
What Is Behind the Decline in ACA Enrollment?
On September 22, CMS said it was canceling about 315,000 enrollments it described as unauthorized, covering more than 760,000 people, a move it expects to return roughly $2.2 billion in subsidies.5
KFF Health News reported that ACA enrollment fell by nearly 3 million this year to about 19.2 million, following steep premium increases and Congress's decision not to extend enhanced subsidies.6 That figure counts paid, or effectuated, enrollment as of February, while CMS counted 23.1 million plan selections during open enrollment.7,8
In an August report, KFF Health News said the administration credits its fraud-control efforts rather than higher premiums for the decline.6 Matthew Fiedler, a senior fellow at the Brookings Institution,
References
1. Trump Administration delivers second year of savings by stopping taxpayer payments for duplicate and deceased enrollees in Obamacare. News release. HHS. October 14, 2026. Accessed October 15, 2026.
2. Kuchno K. CMS ends ACA subsidies for 189,000 duplicate or deceased enrollees: 5 things to know. Becker's Hospital Review. October 14, 2026. Accessed October 15, 2026.
3. Hughes J. Trump administration boots 189,000 deceased, duplicate enrollees off ACA subsidies. Healthcare Dive. October 14, 2026. Accessed October 15, 2026.
4. CMS finds 2.8 million Americans potentially enrolled in two or more Medicaid/ACA exchange plans. News release. CMS. July 17, 2025. Accessed October 15, 2026.
5. CMS cracks down on fraud, waste, and abuse in the Federal Health Insurance Marketplace. News release. CMS. September 22, 2026. Accessed October 15, 2026.
6. Appleby J. Kennedy, Oz contend fraud crackdown, not skyrocketing prices, led millions to leave Obamacare. KFF Health News. August 3, 2026. Accessed October 15, 2026.
7. ACA marketplace enrollment is down by 3 million after big jump in premium payments. KFF. June 2026. Accessed October 15, 2026.
8. Exchange coverage remains near record high as 23.1 million enroll in 2026, reflecting continued strength and stability. News release. CMS. March 27, 2026. Accessed October 15, 2026.
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