When Health and Human Services Secretary Robert F. Kennedy Jr. and Centers for Medicare and Medicaid Services chief Mehmet Oz announced that roughly a million people had been enrolled in Obamacare plans with no Social Security number attached, the figure landed like an immigration scandal. It is something worse.
The number is not primarily a story about who slipped onto the rolls. It is a confession about how the rolls were built, and about an architecture the previous administration engineered to be impossible to audit.
The underlying document is a June 2026 HHS issue brief titled ACA Exchange Enrollment in 2026, written by CMS and HHS economists and obtained by Fox News. Its central finding deserves to be quoted precisely, because the precision is the point. CMS identified, in its words, 1 million highly suspicious agent and broker assisted enrollments through HealthCare.gov with no Social Security number on the application and no premium being paid. Read that again. The common thread is not a border. It is a broker.
How a Safety Net Became a Commission Machine
To understand the phantom million, follow the money the way the brokers did. The American Rescue Plan of 2021 sweetened federal subsidies so generously that anyone earning between 100 and 150 percent of the federal poverty line could obtain a benchmark plan for zero dollars. A free product is a strange thing to police, and the Biden administration declined to police it.
The issue brief catalogs ten separate federal policies that dismantled the program’s own guardrails, among them year-round enrollment for the zero-premium population, the removal of pre-enrollment verifications, and a rule allowing applicants simply to attest to their income when the IRS had no tax record to check it against.
Now add the incentive. Insurance agents and brokers earn between five and thirty dollars per member per month, and by 2024 they were steering 78 percent of all marketplace sign-ups, up from 55 percent three years earlier. Hand a salesman a commission for every warm body he enrolls, strip away the requirement that the body verify its own identity, and design the plan so the enrollee never receives a bill that might tip him off. What did anyone expect would happen? The program was not defrauded despite its rules. It was defrauded because of them.
The Evidence Was Hiding in the Silence
The fraud left fingerprints, and the report lifts them cleanly. If a million people are enrolled in coverage they never sought, the simplest tell is that they never use it. Sure enough, 40 percent of enrollees in zero-premium cost-sharing plans filed no medical claims whatsoever in 2024, roughly double the rate for plans carrying even a token premium. People do not pay for insurance they forget they have, and they do not visit doctors under a policy they never knew existed.
The second fingerprint appears the moment a bill arrives. When phantom enrollees were automatically rolled into plans that finally charged a premium, the share who failed to pay jumped from a historical norm of 18 percent to roughly 50 percent across 2024 through 2026. A ghost cannot write a check. The brokers, meanwhile, had already collected.
The scale is staggering even by Washington’s forgiving standards. The administration estimates that improper, phantom, and fraudulent enrollment peaked at 5.6 million people in 2025, accounting for nearly half of all enrollment growth since the subsidy expansion began.
CMS says it has already cleared about 2.9 million of them from the books while estimating that 2.6 million remain, the equivalent of roughly $10 billion a year siphoned from taxpayers between 2021 and 2024.
A Cleanup the Courts Are Trying to Stop
Here the story turns from administrative malpractice to something closer to a constitutional quarrel. In 2025 the Trump administration finalized the Marketplace Integrity and Affordability Rule, which did the unglamorous work of restoring income checks, ending the year-round loophole, and requiring auto-enrolled recipients to confirm their own eligibility.
It is difficult to construct a principled objection to verifying that federal money reaches the people it was appropriated for. A federal court in Maryland found one anyway, staying key provisions of the rule and, by the report’s own account, blocking CMS from removing hundreds of thousands of additional improper enrollments it had already flagged.
So the present absurdity is this. The agency charged with protecting the Treasury has identified the fraud, named its mechanism, and been ordered by a single district judge to leave a meaningful share of it in place. The same institutional reflex that spent four years looking away from the problem now insists, through the courts, that fixing it is the real overreach.
There is an older verdict on works conducted in the dark. Woe unto them that seek deep to hide their counsel from the LORD, and their works are in the dark, and they say, Who seeth us? and who knoweth us?
The brokers who harvested commissions off neighbors who never consented operated on precisely that assumption, that no one was counting and no one would look. The accounting has arrived regardless.
None of this requires the immigration framing the headlines reached for, and the argument is sturdier without it. The damning fact is not that a million enrollees lacked a particular nine-digit number. It is that an entire federal program was deliberately reconfigured so that nobody would ever have to ask for one.
As CMS put it in the report’s closing, the federal government paying brokers to enroll individuals without their knowledge is not integrity. It is the opposite, dressed up for years as compassion, and the bill has come due for the people who were supposed to be served and the taxpayers who were always going to pay.
