Public Citizen report challenges Trump administration's fraud claims

Nationwide enrollment in the Affordable Care Act plummeted from 22.3 million in 2025 to 17.5 million in 2026. Health and Human Services Director Robert F. Kennedy Jr. and CMS Administrator Mehmet Oz have characterized this five-million-person drop as a victory against program abuse. Oz recently suggested that the previous enrollment levels were excessive, implying that the reduction reflects the removal of ineligible participants.

However, the report from Public Citizen argues that the data contradicts this narrative. Analysts noted that if the administration were successfully targeting fraud, one would expect to see a decline among enrollees claiming incomes near the poverty line, where subsidies are highest. Instead, the loss of coverage is concentrated among low- and middle-income families who faced doubled premiums after congressional Republicans allowed subsidies to lapse. The report concludes these families are not cheaters, but rather individuals unable to sustain rising costs. Meanwhile, the Congressional Budget Office projects that additional GOP-led cuts to Medicaid will reduce that program's enrollment by more than 10 million people by 2034.