The Trump administration announced Tuesday that it had kicked about 750,000 people off Affordable Care Act plans on the suspicion that they either didn’t qualify for the plans, or maybe those people didn’t exist at all. In a news conference, Vice President Couchfucker and Medicare & Medicaid Services (CMS) Administrator Mehmet Oz, who knows fraudulent medicine when he sells it, bragged that the cuts would save the federal government some $2.2 billion, claiming that the ACA was full of fraud that needed to be eliminated.
The cuts were made under the auspices of JD Vance’s “White House Task Force to Eliminate Fraud,” which means that by definition only frauders and cheaters were affected, because it’s right in the name. Vance lied at the presser that “We’re actually making sure that the people receiving Obamacare subsidies are actually entitled to receive them, amazingly we weren’t doing that before,” because Republicans like to pretend that federal programs simply hand out money with no questions asked.
No, the administration didn’t provide details about who had lost coverage, because that’s none of your business and reporters might go and check on those people to find out if they were really doing fraud or what.
Vance couchsplained that the suspected “fraud” cases included people who A) didn’t even know they were on the ACA because dishonest insurance brokers signed them up fraudulently, 2) people who were ineligible for the ACA because they already have health insurance through their employers, and III) people who are ineligible for ACA subsidies because they earn more than 400 percent of the federal poverty level. (Or who didn’t earn enough money, because the Affordable Care Act meant for those folks to get expanded Medicaid, until the Supreme Court kiboshed the requirement for states to take my fucking money dot gif.)
Oh yes, and as Obamacare policy wonk Charles Gaba points out, there’s just one teensy potential problem with that third category. There’s no way for the government to know right now whether people actually make too much to qualify for the ACA this year, at least not until they file their 2026 tax returns early next year. It’s entirely possible, even likely, that thousands of people may have been wrongly booted off their health plans.
Oh. That sounds bad. It may be a while before reporters find out whether that happened or how widespread it might have been. That’s fine for the administration, because they’ve already got their “ACA fraud” narrative out in the news. Anyone saying they wrongly lost their coverage will thus automatically be seen as suspicious, because if they really were eligible for Obamacare they wouldn’t have been kicked off. That’s just logic!
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The 760,000 people yeeted out of Obamacare represent about four percent of the roughly 19 million people still on the ACA. During the Biden administration, ACA enrollments grew from about 10 million to a record high 24 million, largely thanks to increased premium subsidies that began during COVID and and were extended in the 2022 Inflation Reduction Act. For a brief shining moment the percentage of Americans without healthcare coverage reached an all-time low, but then Trump and Republicans repealed the premium subsidies in the Big Evil Bill, jacking up premiums and leaving millions without coverage. (But they all deserved it, we were told.)
In a March 2026 interview with NBC News, Dr. Oz grumbled that “the fact that we have 23 million makes me think we have too many participants in the ACA. […] It’s too high of a number.” At the time, he claimed that there were probably four million, maybe even five million people getting ACA subsidies they weren’t eligible for, because he was just really sure of that.
As Gaba points out, there really has been a problem with fraud by insurance brokers signing up people who shouldn’t be on the ACA. However, he notes, the Biden administration already cracked down on fraudy brokers in 2024, and “the Trump Regime took more aggressive action in 2025, so I find it difficult to believe that there’s that much broker/agent fraud still happening.” (The New York Times said Trump actually recertified the fraudy brokers last year.)
But the idea that hundreds of thousands of Americans make too much income to qualify for the ACA worries Gaba, because in September 2026 it’s too soon for the administration to know whether any of the people booted actually have an income that’s over 400 percent of the federal poverty line, which Gaba nerdily abbreviates as “400% FPL”:
There are millions of Americans who may earn around 400% FPL each year, but whose income can range widely from one year to the next — they might earn more than 400% one year and less the next. When you apply for ACA exchange coverage you have to project your estimated income for the upcoming year. If they project an estimated 2026 income below 400% FPL but end up actually having a MAGI income over 400% FPL, that isn’t fraud.
It’s literally how the ACA is designed to work.
As he explains, if someone does end up making too much to qualify for the ACA, they aren’t charged with fraud. They simply have to repay the full amount of ACA subsidies they received when they file their taxes the next year.
OK, but if the administration won’t actually know until next year whether folks earned more than they anticipated (which, again, not fraud), how did Vance’s team decide people needed to lose their coverage in advance?
If you guessed it was fucking AI, pat yourself on the back, if you can do so without hurting your rotator cuff and having to go back to physical therapy.
Gaba explains: One of the lesser functionaries at the Vance-Oz presser acknowledged that CMS is using AI to speed up the process of stripping eligibility from people and calling it “fraud,” and that’s fine because “it’s not the same standard of proof as like a criminal conviction. It’s basically pattern recognition,” and that’s good enough! In fact, that’s really great, because it allows the agency to “detect fraud before it happens, before claims are paid, and then they can be cut off.”
And if the machine fucks up and kicks you off your ACA health insurance, it’s no big deal because all you gotta do is “appeal back to the agency, explain your situation, and the agency will make payment,” just easy-peasy.
The unidentified dipshit then added that there really must be a whole lot of fraud out there, though, because “as Dr. Oz has said repeatedly, when we do these big cutoffs, almost no one comes.” After all, there couldn’t possibly be any other explanation, like maybe the appeals process isn’t quite so easy as he described it, or people are just too overwhelmed to bash their heads against the wall like that. No worries, only fraudsters and unpeople are affected, please stop complaining.
[NBC News / WSJ (gift link) / NYT (gift link) / Charles Gaba]
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I've already seen posts on Substack from people who have or know someone who has lost their coverage because of this.
How did I miss that the Secret Service started investing GWAR this July for disemboweling Trump on stage, as GWAR does, because we are a vry srs cntry?