U.S. — In a video released on June 27, Health and Human Services Secretary Robert F. Kennedy Jr. praised Centers for Medicare and Medicaid Services head Mehmet Oz for the number of canceled Affordable Care Act plans. "Don't walk away from us, run! Because we are going to find you," Oz said.

Policy experts and critics offered a different explanation for the enrollment drop. Matthew Fiedler, senior fellow at the Brookings Institution, challenged the administration's narrative. "The top-level claim that all the decline in enrollment since 2025 is because of improper or fraudulent enrollees leaving the market is not remotely credible," Fiedler said. "We know that lots of people have seen higher premiums, and there's really good evidence that when premiums go up, people drop coverage."

The average monthly premium for Affordable Care Act customers is $178 in 2026. This figure represents a 58% increase from 2025 levels. The average annual deductible for Affordable Care Act customers is nearly $3,800 in 2026, which represents a 37% increase from previous levels.

Jonathan Oberlander, professor of health policy and management at the University of North Carolina, noted the human impact of these costs. "It will be cold comfort to the very real persons who could no longer afford coverage and dropped their plans," Oberlander wrote in an email.

Regulators have removed 1.5 million people from Affordable Care Act rolls since 2025 for reasons such as failing to file taxes for two years or concurrent enrollment in Medicaid. The Trump administration halted a Biden-era initiative in August 2025 that allowed low-income people to sign up for Affordable Care Act coverage year-round. Brian Blase, president of the Paragon Health Institute, stated the Department of Health and Human Services report's conclusion on the scope of improper enrollment is likely an undercount.

The Centers for Medicare and Medicaid Services told insurers in June 2026 that the agency will send files for Affordable Care Act accounts it believes are potentially unauthorized. Flagged consumer accounts identified by the Centers for Medicare and Medicaid Services used a sales broker to enroll, are in a zero-premium plan, and lack a Social Security or immigration documentation number. Insurers must attempt to contact enrollees in flagged accounts to verify they signed up for coverage. Insurers must report policies they were unable to verify to the Centers for Medicare and Medicaid Services after 60 days, resulting in cancellation.

Centers for Medicare and Medicaid Services spokesperson Christopher Krepich stated the agency will block Affordable Care Act applications made by brokers lacking a Social Security number in summer 2026. The Centers for Medicare and Medicaid Services plans to require more identity-proofing when brokers enroll people by open enrollment in fall 2026. The Centers for Medicare and Medicaid Services plans to limit a broker's access to accounts until the consumer authorizes the broker to work on their behalf by open enrollment in fall 2026. Policy experts including the consulting group Wakely expect Affordable Care Act policyholders to decrease by as much as 26% from the previous year by the end of 2026.

Affordable Care Act coverage increased from just over 11 million Americans in 2021 to more than 22 million in 2025. A KFF poll found that 37% of voters trust Democrats over Republicans to address healthcare costs, compared to 26% for Republicans. A KFF poll found that 55% of Republican voters consider it extremely important for candidates to address healthcare fraud.

The Patient Protection and Affordable Care Act was sponsored by Rep. Rangel, Charles B. [D-NY-15] and became Public Law No: 111-148. PureSource News previously reported that Sanders and Cassidy questioned Kennedy on vaccine and germ theory views. Medicare is US federal health insurance.

The sharp decline in enrollment follows a period of significant growth, with coverage rising from just over 11 million Americans in 2021 to more than 22 million in 2025. The administration attributes the reversal to the removal of fraudulent accounts, citing a report that 5.6 million people were improperly enrolled in 2025. Critics argue that rising costs, including a 58% increase in average monthly premiums, are the primary driver of the drop. The debate shows differing views on the role of fraud versus affordability in healthcare access.

Political implications are evident in polling data, with 55% of Republican voters considering it extremely important for candidates to address healthcare fraud. Conversely, 37% of voters trust Democrats over Republicans to address healthcare costs. The administration has implemented stricter broker oversight and identity-proofing measures to combat fraud, with further restrictions planned for the fall 2026 open enrollment period. These changes aim to prevent unauthorized enrollments but may also impact legitimate access to coverage.

Why It Matters

The sharp enrollment decline follows a period where coverage doubled from 11 million to over 22 million between 2021 and 2025. With premiums rising 58% and deductibles increasing 37%, experts warn that cost increases, rather than fraud removals alone, are forcing people to drop coverage. This shift leaves millions facing higher out-of-pocket expenses or no insurance at all as the administration implements stricter verification protocols.