Trump Administration Targets ACA Enrollment Fraud with Strict New Verification and Marketing Controls

The Trump administration claims success in fighting ACA fraud while proposing stricter income verification and broker regulations for the 2027 marketplace.

By: AXL Media

Published: Mar 28, 2026, 5:56 AM EDT

Source: Information for this report was sourced from KFF Health News

Strategic Shifts in Marketplace Oversight and Regulation

The Trump administration is currently advancing a comprehensive regulatory overhaul of the Affordable Care Act, or ACA, designed to address long-standing concerns regarding enrollment fraud. According to the proposed rule for 2027, the administration intends to implement stepped-up eligibility requirements for subsidies and intensify the scrutiny of sales agents and their marketing practices. While federal officials express optimism that these "program integrity measures" will lead to a decrease in complaints by 2026, the strategy has sent mixed messages to the healthcare industry. Health policy experts, such as Katie Keith of Georgetown University, point out that the administration is simultaneously claiming success in fighting fraud while insisting that even more restrictive consumer controls are mandatory to protect the marketplace.

Income Verification and the Closing of Enrollment Windows

A central component of the new proposal involves stricter documentation for applicants to prove their household income. For instance, individuals whose prior federal data showed earnings below the poverty level must now provide additional verification to demonstrate they expect to earn enough to qualify for subsidies in the coming year. This move follows the administration’s earlier reversal of Biden-era policies, including the elimination of year-round special enrollment periods for low-income populations. According to Matthew Fiedler of the Brookings Institution, there is a distinct trade-off in these provisions, as the burden of proof may prevent valid applicants, particularly small-business owners or part-time workers with fluctuating incomes, from successfully securing coverage.

Escalating Complaints and the Impact of Expired Tax Credits

Despite the administration's claims of success, federal data indicates that the number of complaints regarding unauthorized enrollment or plan switching rose to over 341,000 in 2025. This increase in reported fraud coincided with the expiration of enhanced tax credits, which previously allowed many consumers to enroll in plans with no monthly premium. According to recent polling from KFF, 80 percent of those who remained covered this year reported higher premiums, with over half describing the cost increases as significant. This financial shift has contributed to a year-...