• Nearly 3 million Americans are dually enrolled in Medicaid or subsidized Obamacare plans across multiple states, costing taxpayers billions annually. A new Trump administration crackdown backed by the One Big Beautiful Bill Act aims to eliminate waste, fraud, and abuse, restoring accountability and reducing federal Medicaid spending by an estimated $1 trillion over the next decade.

WASHINGTON, DC (TDR) — The Trump administration is aggressively moving to root out billions in waste from America’s healthcare system, unveiling a data-driven initiative to eliminate dual Medicaid and Obamacare enrollments. The announcement, supported by provisions in the newly signed One Big Beautiful Bill Act, signals a sweeping push to restore fiscal discipline, state oversight, and constitutional accountability in public healthcare policy.

Millions Enrolled Twice, Taxpayers Foot the Bill

New data from the Department of Health and Human Services (HHS) reveals that nearly 3 million Americans are improperly enrolled in Medicaid across multiple states or are simultaneously receiving subsidized Obamacare coverage. HHS estimates this overlap is costing taxpayers $14 billion every year.

“HHS staff uncovered millions of Americans who were illegally or improperly enrolled in Medicaid and [Affordable Care Act] plans,” said HHS 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.”

The agency found that in 2024, an average of 1.2 million Americans per month were enrolled in Medicaid or CHIP in two or more states, and another 1.6 million held both Medicaid and a federally subsidized Obamacare plan—violating federal regulations designed to prevent duplicate coverage.

COVID-Era Oversight Failures Come to Light

Federal law requires states to regularly audit Medicaid and exchange enrollment data to eliminate duplication. However, these reviews were paused under the Biden administration during the COVID-19 pandemic—leading to a surge in unchecked enrollment.

That policy shift coincided with a dramatic expansion of Obamacare. By the end of Biden’s term, exchange enrollment had doubled, reaching nearly 24 million in 2025—up from 12 million at the end of Trump’s first term in 2021. The White House now estimates that 45 million people receive coverage through either the Obamacare marketplace or Medicaid expansion policies.

Oz and Kennedy Lead Targeted Reforms

CMS Administrator Dr. Mehmet Oz announced the agency would collaborate with states to verify enrollees' eligibility and correct discrepancies.

“We will work with states to identify individuals enrolled in multiple programs and fix the duplicate enrollment problem to save taxpayers billions of dollars, while minimizing inappropriate coverage loss,” Oz said.

States will receive updated lists of individuals enrolled in multiple state Medicaid or CHIP programs, while the 19 states and D.C. that operate their own Obamacare exchanges will be required to verify those holding simultaneous Medicaid coverage. Enrollees who fail to act within 30 days will have their premium subsidies terminated.

The One Big Beautiful Bill Act: Real Reform in Action

The reforms are empowered by the One Big Beautiful Bill Act, signed earlier this month by President Trump. The bill tightens Medicaid and Obamacare exchange rules by shortening the open enrollment period, eliminating automatic reenrollment, and requiring income verification for subsidies.

“This is exactly why we fought for stronger tools in the One Big Beautiful Bill Act—to go after this type of waste and finally put a stop to paying twice for the same person’s health coverage,” Oz stated.

According to the Trump administration, the new law is projected to reduce Medicaid spending by $1 trillion over the next 10 years, a major step toward restoring federal budget discipline and curbing entitlement abuse.

Do you believe tighter oversight and eligibility enforcement are the key to restoring integrity in America’s healthcare system?

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