You may have heard that the Centers for Medicare & Medicaid Services (CMS) canceled 315,000 health insurance Marketplace enrollments, affecting more than 760,000 people, citing allegedly unauthorized signups. Vice President J.D. Vance also indicated 419,000 additional enrollees were undergoing further investigation.
Over 19 million people signed up for Affordable Care Act Marketplace plans for the 2026 plan year, down 13% from 2025, which some health policy analysts attribute to premiums that doubled or even tripled after federal subsidies ended.
In a September 22 press release, CMS cited fraud concerns as the reason for the terminated enrollments. Department of Health and Human Services (HHS) Secretary Robert F. Kennedy said he expects that shutting down unauthorized enrollments will return $2.2 billion in federal subsidies. CMS Administrator Dr. Mehmet Oz told the press that the people targeted had not filed a medical claim, filled a prescription, or responded to investigators who tried to contact them by phone, email, and text.
However, CMS has not publicly released data showing how many canceled enrollees had no claims, how long they had been enrolled, or whether lack of claims was a basis for cancellation. Because healthy people don’t file insurance claims, filing zero claims doesn't automatically mean the enrollments were fraudulent. CMS’ formal explanation did state that there was a joint investigation with health insurers who confirmed they were unauthorized.
If you have Marketplace coverage, here’s how to check whether your plan is active, what to do if it was canceled, and how appeals or replacement coverage may work.
How to Tell if CMS Canceled Your Coverage
First, confirm whether your coverage is still active and, if it ended, identify the exact reason and effective date.
- Check your Marketplace account or your state-based exchange account.
- Call your insurer and ask whether your policy is active, terminated, or under review.
- Review Marketplace notices, insurer letters, email, text messages, voicemail, and mail for the effective termination date and stated reason.
- Save screenshots, notices, premium records, enrollment confirmations, medical bills, prescription records, and notes from phone calls.
- If you have an upcoming procedure, ongoing treatment, or a prescription you can't interrupt, tell the insurer and Marketplace immediately.
How to Appeal or Reinstate Coverage
First, determine which review process applies.
Here’s how to appeal eligibility for a Marketplace plan:
- You generally have 90 days from an Eligibility Notice to appeal certain Marketplace determinations. This could include issues such as eligibility to buy a Marketplace plan, eligibility to receive financial assistance, or eligibility to use a Special Enrollment Period.
- According to HealthCare.gov, if the issue is that you need to submit documents to confirm information, such as your Social Security number, you may not need to file an appeal if you submit the requested documentation.
How to make a health plan appeal or grievance:
- HealthCare.gov says you generally can’t use the Marketplace appeal process to challenge a health plan’s decision to end coverage or refuse a claim. Instead, look for your plan’s internal appeal/grievance procedure and ask about expedited review if urgent care is at stake.
How to get replacement coverage:
- An involuntary loss of qualifying coverage often triggers a Special Enrollment Period (SEP), but eligibility depends on why the coverage ended. An SEP is not automatic if your coverage is canceled for alleged fraud. Ask the Marketplace or state exchange whether this particular termination qualifies.
- You need to act quickly; HealthCare.gov gives a 60-day window after a coverage loss for many Special Enrollment Periods.
A Note on Brokers and Agents
In addition to halting enrollments, the Trump administration is freezing new registrations for Obamacare insurance brokers who don’t have an active Exchange Agreement for the 2026 plan year. The moratorium is on registration for the 2027 plan year.
Officials are using a fast-track rulemaking process, which means the policy takes effect without the usual opportunity for the public and industry to comment in advance. Oz said the pause is necessary because officials claim that much of the alleged fraud involved newly registered agents and brokers. Brokers and agents can help consumers apply for Marketplace coverage, compare plans, and complete enrollment.
CMS’ public justification for the rule claims that agents and brokers who registered for the first time in 2026 represent a disproportionate share of unauthorized enrollments.
Consumers can still seek help from currently authorized agents and brokers. If an agent or broker was involved in an enrollment you did not authorize, preserve any records showing who helped you and report the issue to the Marketplace or state exchange.
