CMS ended subsidies in 2026 for 189,000 people with federally subsidized marketplace coverage who also had Medicare, Medicaid or Children’s Health Insurance Program coverage, or who were deceased, HHS said Oct. 14.
Here are five things to know:
1. The Trump administration in 2025 restored duplicate enrollment enforcement and ended duplicate marketplace subsidies for about 551,000 enrollees who were already on Medicaid. CMS Administrator Mehmet Oz, MD, said the agency has saved nearly $6 billion. At an Oct. 14 news conference, HHS Secretary Robert F. Kennedy Jr. said CMS estimates the 2026 work will prevent $738 million in improper subsidy payments this year. HHS said the effort could save taxpayers about $1.5 billion annually.
2. Medicaid overlap made up the largest share of the 2026 cases. About 120,000 of the 189,000 cases involved duplicate Medicaid coverage, Dr. Oz said at the news conference. That is down from about 551,000 in 2025, though still above the historical level of roughly 55,000 dual Medicaid-ACA enrollees, he said.
3. Medicare and deceased enrollees made up the rest. Roughly 58,000 cases involved duplicate Medicare coverage, down from 93,000 in 2024, said Peter Nelson, who oversees the ACA marketplace. About 11,000 deceased enrollees had subsidies ended through July, and CMS expects to remove another 3,500 by the end of October.
4. Enrollees whose records show duplicate coverage get 30 days to dispute the match or cancel the duplicate coverage. If they do not respond, CMS ends the subsidies for their marketplace plan. For deceased enrollees, CMS contacts the estate and gives it 30 days to dispute the record. If the record is not disputed, CMS cancels the subsidy and the plan. At the news conference, Dr. Oz said enrollees who do not respond default to Medicaid. Mr. Nelson said about half of the people notified in the first Medicaid round resolved the match before the deadline, and that no one lost coverage.
5. CMS Medicaid Director Dan Brillman said the agency found about 1.2 million people a month who appeared to be enrolled in Medicaid or CHIP in more than one state. Starting in January, states will be required to regularly obtain and verify enrollee address information. Mr. Brillman said CMS is also building a national system that states will use to check enrollment monthly.
At the Becker's 5th Annual Fall Payer Issues Roundtable, taking place November 2–3 in Chicago, payer executives and healthcare leaders will come together to discuss value-based care, regulatory changes, cost management strategies and innovations shaping the future of payer-provider collaboration. Apply for complimentary registration now.
