The Centers for Medicare & Medicaid Services (CMS) has identified a significant issue with duplicate enrollments in government health programs, potentially saving taxpayers $14 billion annually. A recent analysis of 2024 enrollment data revealed that 2.8 million Americans are either enrolled in Medicaid or the Children’s Health Insurance Program (CHIP) across multiple states or are simultaneously enrolled in both Medicaid/CHIP and a subsidized Affordable Care Act (ACA) Exchange plan.
To address this, CMS is implementing measures to ensure individuals are only enrolled in one program, preventing the federal government from making multiple payments for the same coverage. The One Big Beautiful Bill Act provides CMS with new tools to prevent duplicate payments and restore system integrity.
"HHS staff uncovered millions of Americans who were illegally or improperly enrolled in Medicaid and ACA plans," said U.S. Health and Human Services Secretary Robert F. Kennedy, Jr. He emphasized that under the Trump Administration, waste, fraud, and abuse will not be tolerated.
CMS Administrator Dr. Mehmet Oz highlighted the administration's commitment to resolving these issues: "The Biden Administration struggled to ensure that individuals were only enrolled in the single Medicaid or Exchange plan for which they were eligible, that ends today." He added that CMS is restarting checks to comply with federal law and working with states to identify and resolve duplicate enrollments.
In 2024, an average of 1.2 million Americans each month were found to be enrolled in Medicaid/CHIP in two or more states, while another 1.6 million were enrolled in both Medicaid/CHIP and a subsidized Exchange plan monthly. Federal regulations mandate periodic data matching to prevent improper enrollments.
CMS plans three initiatives: providing states with lists of individuals enrolled in multiple programs; notifying those with dual enrollments between Medicaid/CHIP and Federally-facilitated Exchange plans; and collaborating with State-based Exchanges on similar issues.
Additional guidance will be issued to state agencies by early August, followed by lists of concurrently enrolled individuals for eligibility rechecks by late fall. CMS aims to support existing data matching processes while implementing new requirements from the One Big Beautiful Bill Act.
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