Nearly three million Americans are either enrolled in Medicaid in multiple states or are simultaneously enrolled in both Medicaid and a subsidized Obamacare exchange insurance plan, according to new analysis from the Health and Human Services Department.

Eliminating these overlapping enrollments would save an estimated $14 billion annually, according to a press release from the Centers for Medicare and Medicaid Services. 

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“HHS staff uncovered millions of Americans who were illegally or improperly enrolled in Medicaid and [Affordable Care Act] plans,” said HHS Secretary Robert F. Kennedy, Jr. “Under the Trump Administration, we will no longer tolerate waste, fraud, and abuse at the expense of our most vulnerable citizens.”

President Donald Trump and his Cabinet officials have said that rooting out waste, fraud, and abuse is a central goal of the new administration. 

The press release said that, over the past several months, the agency that oversees Medicaid and the Children’s Health Insurance Program has reviewed historical program enrollment data to identify program inefficiencies.

Analysts found that in 2024, an average of 1.2 million Americans each month were enrolled in Medicaid or CHIP in two or more states. Another 1.6 million Americans each month were enrolled in both Medicaid or CHIP and a subsidized Obamacare plan. 

Federal regulations require states to periodically check for dual enrollment in Medicaid and Obamacare exchange plans, but these examinations were paused under the Biden administration during the COVID-19 pandemic to ensure that people did not lose their coverage during the public health emergency.

Enrollment in Obamacare exchange plans doubled during former President Joe Biden’s term, with nearly 24 million Americans signing up following the January 2025 open enrollment period. 

When Trump’s first term ended in 2021, only 12 million Americans were enrolled in Obamacare coverage.

The White House estimated in January that 45 million people were covered under either Obamacare marketplace exchange insurance plans or Medicaid expansion policies for nondisabled adults without dependents. 

CMS Administrator Dr. Mehmet Oz said in Thursday’s announcement that his agency will “work with states to identify individuals enrolled in multiple programs and fix the duplicate enrollment problem to save taxpayers billions of dollars, while minimizing inappropriate coverage loss.”

The agency says it will provide states with a list of individuals enrolled in multiple states’ respective Medicaid or CHIP programs to verify their eligibility. 

The 19 states and Washington, D.C., operating their own state-based health insurance marketplace under Obamacare will also get a list of individuals additionally enrolled in their jurisdiction’s Medicaid program to conduct eligibility determinations. 

Individuals enrolled in both Medicaid and a federally facilitated subsidized exchange who do not act to rectify the situation within 30 days will have their premium subsidy terminated. 

Both Oz and Kennedy praised the GOP’s One Big Beautiful Bill Act, signed by President Donald Trump earlier this month. The legislation makes substantial changes to the Medicaid and Obamacare programs and is advertised as eliminating waste. 

“This is exactly why we fought for stronger tools in the One Big Beautiful Bill Act—to go after this type of waste and finally put a stop to paying twice for the same person’s health coverage,” said Oz.

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Under the new law, Medicaid spending is expected to decrease by $1 trillion below previously anticipated levels over the next 10 years.

The reconciliation bill also made substantial changes to technical functions of the Obamacare exchange, including reducing the open enrollment window, eliminating automatic enrollment, and preventing enrollees from self-attesting income.