A federal fraud investigation announced this week by Vice President JD Vance removed 760,000 Americans from Affordable Care Act coverage, according to a Newsday report examining the probe's impact and implications. The investigation focused on the federal exchange, which serves as the enrollment platform for consumers in 28 states, but didn't include New York because the state operates its own exchange. Health policy experts interviewed by Newsday raised concerns about whether the mass removal included people with legitimate coverage and questioned what protections New York has against similar fraud.
New York's state-run ACA marketplace currently covers 271,511 residents through traditional "qualified health plans," including 25,971 people in Nassau County and 26,525 in Suffolk County, according to state Health Department data. The state Department of Health told Newsday it uses multiple checks to prevent fraudulent enrollment, relying on various federal and state electronic data sources that are regularly updated to verify applicants' eligibility. These verification processes undergo regular audits by federal, state, and independent auditors, the department said. Trump administration officials said much of the fraud on the federal exchange involved brokers who enrolled people without their knowledge or submitted fake names to collect enrollment commissions.
Bill Hammond, a senior fellow focusing on health policy at the Manhattan Institute, a conservative think tank, said fraud in New York's ACA marketplace is rare compared to other states. "If it exists at all in New York, it's not as widespread as it would be in other states," he told Newsday, adding that "the evidence is that it's the federal exchange" where most fraud happens. But Jason Levitis, a senior fellow at the Urban Institute and former Obama administration Treasury official, questioned the criteria used for the purge: "It's crucial to go after fraud whenever you can. But you have to do so following the rules, and you have to be fair and transparent about it. Here CMS hasn't really explained what they did." Neither the White House, Vance's press office, nor the Centers for Medicare & Medicaid Services responded to Newsday's requests for comment.
Experts said the wholesale removal approach raises red flags about due process and accuracy. Hammond noted this wasn't the standard method for fighting fraud, which typically requires case-by-case action with specific evidence about individual people rather than categorical removals. He acknowledged significant waste and fraud exists in the program, citing a December 2025 Government Accountability Office review that found auditors could enroll in the federal marketplace without verifying their Social Security numbers. But he warned there's "a risk this administration is going too far in the other direction" and could be removing people who genuinely need and deserve coverage. Vanessa Baird-Streeter, president and CEO of the nonprofit Health and Welfare Council of Long Island, expressed concern that some people who didn't commit fraud, including those who may have made honest paperwork mistakes, could have been caught in the purge.
Levitis warned that the Trump administration has tried to undermine the ACA through various legal and administrative actions, "so it only makes sense to be concerned that there will be more along those lines, including actions like this, coming to state-based marketplaces in the future." Vance, who launched the ACA investigation as part of his ongoing "anti-fraud task force," has already targeted New York, headlining a task force event in Bethpage in June where he accused the Hochul administration of mismanaging a Medicare program for disabled patients receiving at-home care. The state Department of Health called his claims "baseless." The lack of transparency about the federal purge's criteria leaves open the question of whether legitimate enrollees lost coverage alongside fraudulent ones.