The Centers for Medicare and Medicaid Services (CMS) in the United States announced on Thursday (July 17th) that millions of people are simultaneously joining government healthcare programs in multiple states or registering for multiple plans, resulting in taxpayers losing about $14 billion annually.
This announcement follows an analysis of 2024 enrollment data for the Medicaid, Children’s Health Insurance Program (CHIP), and Affordable Care Act Exchange.
The investigation found that in 2024, approximately 1.2 million people simultaneously registered for Medicaid or CHIP in two or more states, while another 1.6 million individuals, who registered for Medicaid or CHIP, also enrolled in subsidized Exchange plans.
The total number of “duplicate enrollees” amounted to around 2.8 million people.
Health and Human Services Secretary Robert F. Kennedy Jr. stated in a declaration, “Under the leadership of the Trump administration, we no longer tolerate wasteful, fraudulent, and abusive behavior at the expense of our most vulnerable citizens.”
Duplicate enrollments result in financial waste and do not provide additional medical care for patients.
About 75% of Medicaid enrollees and a higher percentage of Exchange enrollees are enrolled in Managed Care Plans. Under this system, the government pays a fixed fee to insurance companies monthly to provide necessary medical services to insured individuals. In cases of duplicate registration, the government ends up paying two premiums for the same person.
Some Medicaid enrollees, upon moving to another state, register for Medicaid in the new state but forget to cancel their registration in the original state, inadvertently resulting in duplicate enrollment.
In other instances, when certain enrollees have an increase in income rendering them ineligible for Medicaid, they switch to Exchange insurance without canceling their original Medicaid registration.
Federal regulations require data verification every six months to eliminate duplicate registrations. However, during the COVID-19 pandemic, this verification process was temporarily suspended to prevent people from losing health insurance.
CMS Director Dr. Mehmet Oz mentioned that the agency will resume regular and thorough registration data reviews.
He said, “This is precisely why we advocated for strengthening anti-fraud tools in the One Big Beautiful Bill Act – to address such waste and prevent duplicate payments for medical insurance for the same individual.”
The federal government will collaborate with states to check registration lists while ensuring that eligible individuals do not lose coverage. When a beneficiary is suspected of dual registration, both states will be notified for verification.
CMS will also notify individuals listed in Medicaid, CHIP, and Obamacare simultaneously to cancel one registration or inform the Exchange that the information is incorrect.
In 2024, the United States spent over $618 billion on Medicaid. Duplicate registrations are just one form of many wasteful expenditures.
The One Big Beautiful Bill Act includes several provisions aimed at ensuring that only eligible beneficiaries can join the program.
One provision, effective in October 2027, mandates beneficiaries to verify their eligibility every six months instead of annually to eliminate those exceeding income limits and unlawful residents.
According to data from the Congressional Budget Office, approximately 1.4 million undocumented immigrants registered for Medicaid.
Furthermore, the Act requires certain Medicaid enrollees to engage in 20 hours of work, education, training, or community service activities weekly. This requirement, only applicable to non-disabled adults without children or other dependents, will take effect as early as January 1, 2027.
According to the Kaiser Family Foundation’s health policy institute, about 90% of Republicans and over half of Democrats support these new regulations.
However, critics from the progressive think tank, the Center for Budget and Policy Priorities, Gideon Lukens and Elizabeth Zhang, argue that the requirements regarding minimum hours create administrative barriers and complex processes, leading even exempted working individuals and policymakers to potentially lose insurance eligibility.
They pointed out, “These provisions may also result in individuals in job transitions losing coverage.”
As of March 2025, approximately 71 million people are enrolled in Medicaid, while 7 million participate in CHIP programs, and around 24 million individuals are in the Affordable Care Act Exchange plans.