Wyden, Sanders and 11 Senate Democrats Send Letters to 10 ACA Insurers Over 760,000 Coverage Terminations

Since the Trump administration announced in September that it was removing about 760,000 people from Affordable Care Act marketplace coverage over alleged fraud, the fight has moved from the administration to the insurers who carried out the outreach. On Monday, Oct. 26, Sens. Ron Wyden (D-Ore.) and Bernie Sanders (I-Vt.), joined by 11 other Senate Democrats, sent letters to the CEOs of 10 of the largest ACA carriers.

The recipients are UnitedHealthcare, AmeriHealth Caritas, Centene, Cigna, Elevance, Florida Blue, Health Care Service Corporation, Imperial Insurance Companies, Oscar and Molina. Punchbowl News first reported the letters.

What the senators allege

The letters accuse the insurers of choosing "to participate in a collaborative effort with the Trump administration to inject yet more chaos and damage into the ACA Marketplace." The senators say they have "serious concerns" that carriers helped remove "qualified enrollees" without sufficient notice or required consumer protections.

According to the senators, insurers sent unsolicited messages, in some cases asking enrollees to verify their Social Security numbers. Anyone who did not respond was treated as fraudulent and dropped. These are the senators' allegations.

The senators also say the administration relied on "discredited, partisan analyses" that treat zero-dollar premium plans and zero-claims enrollees as proxies for fraud. They fault the insurers for not asking CMS what legal authority it was relying on and for not raising concerns with Congress.

The timing complaint

One charge is specific. The senators say insurers "almost universally" declined to warn enrollees about big premium increases ahead of 2026 open enrollment, despite repeated Democratic requests. The carriers cited the complexity and cost of mid-year contact and delays in finalizing premiums.

But when Republicans and CMS asked for outreach to flag possible fraud, the senators say, enrollee communications went out "within weeks, if not days." The letter to Cigna adds that the company receives "billions of dollars in premiums and taxpayer support each year."

The administration's position

The administration says the terminations were justified. The Trump administration has said the people removed were ineligible for coverage or, in some cases, did not exist. CMS Administrator Mehmet Oz has said, "Fraud will destroy Obamacare." Vice President JD Vance has said fraud is making health care more expensive.

Supporters call the sweep overdue. Brian Blase of the Paragon Health Institute, whose research underpins many of the fraud claims, says so. Paragon's findings are disputed, and the senators call such analyses partisan.

America's Health Insurance Plans, the industry trade group, did not address the letters directly. Spokesperson Chris Bond said insurers "continue to support policies that ensure eligible Americans can access affordable coverage options through the individual market" and also back "strong program integrity measures to safeguard consumers and taxpayers."

Some people are being put back

Not everyone removed was fraudulent. Insurance industry sources told KFF Health News that CMS has reinstated a small number of people whose coverage should not have been canceled, and more could follow as enrollees discover they are uninsured at the pharmacy or doctor's office. David Merritt of the Blue Cross Blue Shield Association confirmed some BCBS members were among those reinstated. He said CMS has an expedited review for people improperly disenrolled.

CMS and the Department of Health and Human Services have given few details on how extensive the outreach was, how long reinstatement takes, or how many cancellations have been reversed. Katie Keith, a director at Georgetown Law's Center for Health Policy and the Law, said: "It may be true that some of those enrollments were not authorized, but it can be equally true that people got lost in the shuffle and have a valid enrollment. Without more information, it's almost impossible to tell."

Other policy experts have questioned how many legitimate consumers were swept up, perhaps because they missed a letter or a phone call.

Why it matters now

The letters landed a week before Election Day. If Democrats win the Senate, Wyden would chair the Finance Committee and Sanders the Health, Education, Labor and Pensions Committee, both with oversight of the insurance industry. Insurers now face pressure from two directions. Republicans have argued that the enhanced ACA subsidies were a giveaway to carriers, and Democrats now say the carriers helped strip coverage.

The fraud question is real. Enrollments that belong to nobody, or to people who never asked for coverage, cost taxpayers money. The documented problem is that the government has not shown how many of the 760,000 were phantoms and how many were real people who did not answer a letter. A $0-premium plan with no claims can mean fraud. It can also mean a healthy person who never needed care.

A second phase is already running. About 419,000 more sign-ups are under review. Merritt said insurers must tell CMS how many of those enrollees fail to respond to outreach "around mid-to-late November, after the midterm elections." That report, and any count of reinstatements before it, will show whether the first sweep caught mostly ghosts or mostly people who were simply hard to reach.