For years, Washington celebrated soaring Obamacare enrollment numbers as proof the system was working. Now the numbers are being viewed through a very different lens.
The Trump administration says a significant share of that explosive growth was never legitimate to begin with.
As part of a government-wide anti-fraud push, the Department of Health and Human Services uncovered what officials estimate could amount to roughly $10 billion in improper Obamacare spending tied to fraudulent, phantom, and ineligible enrollments — and millions of those enrollments are already being removed.
According to a report obtained by Fox News Digital, federal officials launched a deeper review after Obamacare enrollment ballooned during the Biden years. At the start of Biden’s term, roughly 10 million people were enrolled in the Affordable Care Act marketplace. By the program’s 2024 peak, that number had surged to 22 million.
The question became obvious: Was all of that growth real?
Trump administration officials say the answer, in many cases, was no.
The report estimates that improper, phantom, and fraudulent enrollment reached as high as 5.6 million people in 2025. Of those, nearly three million have already been removed from the rolls, with another 2.6 million targeted for cleanup.
The report also states that more than one million remaining enrollments currently lack a Social Security number.
Officials point to policy changes made during the Biden administration that loosened eligibility checks, relaxed income verification standards, and expanded year-round enrollment opportunities. According to the findings, those changes created openings that bad actors exploited.
Among the practices identified were applicants misstating income levels to qualify for taxpayer-funded subsidies, duplicate enrollment issues involving Medicaid, and so-called “phantom enrollments,” where insurance brokers allegedly signed people up without their knowledge in order to generate commissions.
That last category may be one of the most politically uncomfortable details of all. Inflated enrollment totals can make a program appear stronger on paper while taxpayers quietly absorb the cost.
The Trump administration says it has reversed course.
Federal officials restored income verification requirements, tightened enrollment windows, checked for duplicate Medicaid participation, investigated broker abuse tied to phantom accounts, and eliminated several special enrollment pathways that officials believe were vulnerable to misuse.
Even after the removals, roughly 19.2 million people remain enrolled in Obamacare.
The administration’s message is straightforward: healthcare programs exist to serve eligible Americans — not to become open-ended systems vulnerable to manipulation, weak oversight, and subsidy gamesmanship.
Because public trust does not survive forever. If taxpayers are expected to fund government programs, they expect those programs to follow rules, verify eligibility, and protect the people they were actually built to serve. That part should not be complicated.
