• President Trump’s administration moves to eliminate 2.8 million duplicative Medicaid and ACA enrollments, aiming to save $14 billion annually. Conservatives hail the policy as long-overdue fiscal stewardship, while Democrats warn of potential harm to low-income Americans. The One Big Beautiful Bill Act stands at the center of this unfolding health policy debate.

WASHINGTON, DC (TDR) — The Trump administration has embarked on an ambitious effort to streamline federal health benefits by removing millions of duplicative enrollees from Medicaid and Obamacare plans—a reform measure the White House says will protect taxpayers and preserve program integrity.

The Centers for Medicare & Medicaid Services (CMS) announced that an estimated 2.8 million Americans were improperly enrolled in more than one government health plan each month in 2024, triggering double payments and systemic waste. The newly enacted One Big Beautiful Bill Act gives the federal government authority to correct these redundancies—projected to save $14 billion per year.

Waste, Fraud, and Fiscal Responsibility

The dual-enrollment issue spans both geographical and programmatic lines. CMS data show that, on average, 1.2 million individuals were simultaneously enrolled in Medicaid or CHIP programs across two or more states. An additional 1.6 million people were covered by both Medicaid/CHIP and a subsidized Affordable Care Act marketplace plan.

“HHS staff uncovered millions of Americans who were illegally or improperly enrolled in Medicaid and ACA plans,” said Health and Human Services Secretary Robert F. Kennedy Jr. “Under the Trump administration, we will no longer tolerate waste, fraud, and abuse at the expense of our most vulnerable citizens.”

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Conservatives have long decried duplicative enrollment as symptomatic of a bloated and unaccountable bureaucracy. The Trump administration’s latest action marks a broader return to the constitutional principle that government exists to serve the public—not itself.

Republican Lawmakers Applaud

Leading Republicans quickly endorsed the reform initiative, framing it as a principled attempt to enforce fiscal discipline and safeguard safety-net programs for those who need them most.

“I applaud President Trump for taking decisive action to remove 2.8 million duplicative enrollees,” said Rep. Brett Guthrie, chairman of the House Energy and Commerce Committee. “This builds upon work by House Republicans in the One Big Beautiful Bill that gives tools to CMS and the States to prevent wasteful spending like this from happening again.”

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Sen. Chuck Grassley of Iowa, a long-time advocate for curbing federal health fraud, added:

“It’s unacceptable that taxpayers have continued to foot the bill for this expensive fraud. CMS’s actions build on Republicans’ successful work to strengthen health care while curbing fraud.”

Partisan Fault Lines on Health Policy

Democrats, by contrast, accuse the administration of using fraud prevention as a pretext to undermine public health insurance altogether.

“Republicans have supported the largest cut to Medicaid in American history,” House Minority Leader Hakeem Jeffries claimed during a CNN interview. “This bill will rip coverage away from millions of Americans.”

Jeffries further warned that the bill could reduce Medicare funding by more than $500 billion and harm the Children’s Health Insurance Program and Planned Parenthood.

A Clash of Visions

At the heart of this debate lies a fundamental question: Should the federal government prioritize program efficiency and solvency—or maximize participation, regardless of duplication and potential abuse?

President Trump’s position is unmistakable: responsible governance requires a relentless commitment to rooting out waste, especially in entitlement programs that risk fiscal collapse if left unchecked.

Is fiscal discipline compatible with compassionate care—or are Americans being asked to choose between the two? Share your thoughts in the comments.

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