760,000 ACA cancellations: senators press 10 insurers

CMS canceled federal marketplace coverage for more than 760,000 people on Aug. 31, according to a CMS fact sheet. Now 13 Senate Democrats want the insurers that helped to explain how it happened.

The senators sent letters to the chief executives of 10 insurers, Sen. Ron Wyden’s office said on Oct. 27. Wyden is the top Democrat on the Senate Finance Committee. Sen. Bernie Sanders, the top Democrat on the HELP Committee, signed with him, along with 11 others.

Who got a letter

• Cigna
• UnitedHealthcare
• Centene
• Elevance
• Oscar Health
• Molina Healthcare
• Florida Blue
• Health Care Service Corporation
• AmeriHealth Caritas
• Imperial Insurance Companies

What CMS says it did

CMS says the cancellations covered about 315,000 enrollments. It says each one was confirmed as unauthorized after a review it ran with insurers under its existing process. The agency expects about $2.2 billion in advance premium tax credits to come back to the government.

CMS also said it would keep working with insurers to find and cancel more of these enrollments. It has sent termination notices to more than 200 agents and brokers since January and paused new broker registrations for 2027.

What the senators say went wrong

The senators call the process flawed. They say insurers sent members unsolicited messages, in some cases asking them to verify Social Security numbers. People who did not answer were treated as fraudulent and lost coverage, the release says.

The senators say the screening leaned on signs that do not prove fraud. Those include a $0 premium after subsidies, no claims or a missed letter. And they say insurers did this months before CMS tried to change its guidance to allow it.

“This year, nearly 3 million people have lost coverage,” the senators wrote. They say millions more pay higher premiums and deductibles for insurance that covers less.

They asked each company to answer five questions:

• When CMS first contacted it, and whether CMS gave a legal basis.
• Why it ran midyear eligibility checks that conflicted with the federal exchange manual at the time.
• Whether it sees a $0 premium, no claims or an unanswered letter as proof of fraud.
• How many terminated members have filed a claim or asked to be reinstated.
• Whether it is taking part in a second round of terminations now underway.

What insurers say

AHIP is the insurer trade group. It told Punchbowl News that its members “continue to support policies that ensure eligible Americans can access affordable coverage options through the individual market.” It also backs “strong program integrity measures to safeguard consumers and taxpayers,” spokesperson Chris Bond said.

Democrats are in the minority. Wyden and Sanders would chair the two committees if their party wins the Senate in the Nov. 3 election, Punchbowl reported.

What to do if you buy your own coverage

Open enrollment for 2027 marketplace plans starts Nov. 1 on HealthCare.gov. Read every letter your insurer or the marketplace sends. Answer requests to confirm your identity or income by the deadline. If your plan was canceled and you think it was a mistake, call the marketplace and ask how to appeal.

More checks are coming. CMS has proposed holding back subsidies until a marketplace verifies income and citizenship, starting with 2028 plans. We covered that rule here. Centene alone lost 2.4 million marketplace members in the past year.

Why it matters: CMS calls the 760,000 cancellations fraud cleanup. The senators call them terminations without due process. Ten insurers are now being asked to say which one it was.