Dr. Mehmet Oz, administrator of the Centers for Medicare & Medicaid Services, said Monday that the Affordable Care Act is experiencing widespread fraud, claiming that millions of individuals receiving benefits should not be enrolled in the system. Oz made the remarks during an interview on Newsmax’s “The Record With Greta Van Susteren,” as reported [1] by Newsmax.
“We believe there are over 4 million people, alleged people, getting benefits on the Obamacare system who do not exist or weren’t supposed to get the benefits,” Oz said.
“That’s a lot of money. Full fare, we’re paying for insurance for 4 million people who don’t even know they have insurance.”
Oz noted that his estimate significantly exceeds figures from a report issued in mid-July under the Trump administration.
That analysis found “2.8 million Americans either enrolled in Medicaid or the Children’s Health Insurance Program in multiple states or simultaneously enrolled in both Medicaid/CHIP and a subsidized Affordable Care Act exchange plan.”
Oz attributed the current level of fraud to policy decisions made during the pandemic.
“When the original ACA was created, there were problems with it, which, for good or for bad, they were sort of muddling through until COVID,” he said.
“And when COVID hit, the Democrats addressed those problems by throwing money at the issue, which they only were willing to do until now, because they knew what they were doing didn’t make sense.”
According to Oz, those decisions created opportunities for abuse. “Because of these ill-designed moves, it has led to immense fraud in the system,” he said.
Oz also addressed broader concerns about healthcare costs. “Look at healthcare costs in general. They’re increasing 8 to 9% this year. That’s a lot more than inflation. The GDP can’t keep up with that,” he said.
He said new systems and procedures under review at CMS are intended to address both fraud and long-term cost pressures.
“We’re going to become a large healthcare system with a small country attached. So let’s get ahead of this,” Oz said.
He added, “We do have big ideas there, but it’s a mix. You have to reduce the actual cost of care while you come up with better ways of paying for the care that you’re offering.”
President Donald Trump has raised related concerns, proposing a change to how federal healthcare funding is used.
During the federal government shutdown, he suggested redirecting federal dollars currently paid to insurance companies under the Affordable Care Act directly to individuals.
“I am recommending to Senate Republicans that the Hundreds of Billions of Dollars currently being sent to money sucking Insurance Companies in order to save the bad Healthcare provided by ObamaCare, BE SENT DIRECTLY TO THE PEOPLE SO THAT THEY CAN PURCHASE THEIR OWN, MUCH BETTER HEALTHCARE, and have money left over,” Trump wrote in a social media post.
Totally agree, @POTUS [2]! I’m writing the bill right now.
We must stop taxpayer money from going to insurance companies and instead give it directly to Americans in HSA-style accounts and let them buy the health care they want. This will increase competition & drive down costs. pic.twitter.com/GbTdbTWP8b [3]
— Rick Scott (@SenRickScott) November 8, 2025 [4]