联邦将停发18.9万人奥巴马医改补贴：同时参加医保或医疗补助、或已去世仍在领补贴者被查出，预计今年避免7.38亿美元不当支付
华盛顿——美国卫生与公众服务部部长小罗伯特·F·肯尼迪（Robert F. Kennedy Jr.）10月14日在华盛顿的记者会上宣布，联邦医疗保险与医疗补助服务中心（CMS）已查出约18.9万人不符合领取《平价医疗法案》（即奥巴马医改）补贴的资格，将停发这批人的补贴。
据卫生部当日发布，CMS核查发现，这批人在2026年领取联邦医保交易平台（HealthCare.gov）的补贴保费的同时，还参加了联邦医疗保险（Medicare）、医疗补助（Medicaid）或儿童健康保险计划（CHIP）等其他政府医保项目，另有一部分人已经去世、名字却仍留在补贴名单上。肯尼迪在记者会上表示，联邦政府为交易平台的保单支付补贴时，有义务核查这笔钱是否应当支付，「我们显然不能继续为已经去世的人付钱」。他还表示，纳税人不应为重复参保买单。
按CMS在记者会上公布的构成，这18.9万人中约12万人涉及与医疗补助重复参保，由CMS主任穆罕默德·奥兹（Mehmet Oz）公布；约5.8万人涉及与联邦医疗保险重复参保，由负责医保交易平台的CMS副主任彼得·纳尔逊（Peter Nelson）公布，该数字低于2024年的9.3万人；已去世者中，截至今年7月已有约1.1万份补贴保单被终止，CMS预计10月底前再处理约3500人。
卫生部估计，这一行动将避免今年约7.38亿美元的不当补贴支付，按全年折算超过15亿美元；政府预计到今年年底，可避免的不当补贴覆盖月份将超过100万个月。
按CMS公布的程序，被记录显示重复参保的人会收到通知，并有30天时间提出异议或取消重复的保单；去世者的遗产管理方同样有30天时间提出异议；逾期不回应者，其交易平台保单的补贴将被终止。奥兹在记者会上表示，未回应者将默认转入医疗补助；纳尔逊表示，第一轮医疗补助核查中被通知者约有一半在期限前解决了重复记录问题，且无人因此失去医保。官员们在记者会上强调，许多被查出者本人并不知情自己重复参保，他们通常保留原有的联邦医疗保险、医疗补助或儿童健康保险，不会失去保障。
背景方面，特朗普政府2025年恢复了重复参保核查，当年已终止约55.1万名同时参加医疗补助者的交易平台补贴；奥兹表示，该机构迄今已节省近60亿美元。CMS医疗补助主任丹·布里尔曼（Dan Brillman）在记者会上表示，该机构发现每月约120万人似乎在不止一个州参加了医疗补助或儿童健康保险；自明年1月起，各州将被要求定期获取并核实参保人地址信息，CMS正在建设一套供各州每月核查参保记录的全国系统。
另据路透社报道，副总统万斯（JD Vance）今年9月曾表示，政府已暂停超过76万名被认为系欺诈性注册者的奥巴马医改参保，估计可节省22亿美元；奥兹在10月14日记者会上表示，本次行动与上月宣布的那次行动相互独立、并非同一批处理。
US to End Obamacare Subsidies for 189,000 People Found Duplicately Covered or Deceased; $738 Million in Improper Payments to Be Prevented This Year
Washington — U.S. Health Secretary Robert F. Kennedy Jr. announced at a press conference in Washington on October 14 that the Centers for Medicare and Medicaid Services (CMS) will end Affordable Care Act subsidies for about 189,000 people it has identified as ineligible, according to a Department of Health and Human Services (HHS) release issued the same day.
CMS found that the 189,000 people were receiving subsidized coverage through the federal marketplace, HealthCare.gov, in 2026 while also enrolled in another government program — Medicare, Medicaid or the Children's Health Insurance Program (CHIP) — or had died while remaining on the subsidy rolls, HHS said. Kennedy told the press conference that when the federal government pays a subsidy for a HealthCare.gov plan, it has an obligation to check whether that payment is owed, adding: "We certainly can't keep paying for people who are deceased." He also said taxpayers should not foot the bill for duplicate coverage.
By category, about 120,000 of the cases involved duplicate Medicaid coverage, CMS Administrator Mehmet Oz said at the press conference. About 58,000 involved duplicate Medicare coverage, down from 93,000 in 2024, said Peter Nelson, the CMS deputy administrator who oversees the marketplace. Subsidies for about 11,000 deceased enrollees had been ended through July, and CMS expects to remove another 3,500 by the end of October.
HHS estimated the action will prevent about $738 million in improper subsidy payments this year, a figure exceeding $1.5 billion on an annualised basis, and the government expects to prevent more than one million months of improperly subsidized coverage by the end of the year.
Under the CMS procedure, people flagged for duplicate coverage are notified and given 30 days to dispute the match or cancel the duplicate coverage; the estates of deceased enrollees are likewise given 30 days to respond. If there is no response, CMS ends the marketplace subsidies. Oz said non-respondents default to Medicaid, and Nelson said about half of those notified in the first Medicaid round resolved the match before the deadline and that no one lost coverage. Officials stressed at the press conference that many of those identified do not know they are double-enrolled and typically keep their Medicare, Medicaid or CHIP coverage.
The administration restored duplicate-enrollment enforcement in 2025 and ended duplicate marketplace subsidies for about 551,000 enrollees who were already on Medicaid; Oz said the agency has saved nearly $6 billion. CMS Medicaid Director Dan Brillman said the agency found about 1.2 million people a month who appeared to be enrolled in Medicaid or CHIP in more than one state; starting in January, states will be required to regularly obtain and verify enrollee address information, and CMS is building a national system for states to check enrollment monthly.
Separately, Reuters reported that Vice President JD Vance said in September that the administration was halting enrollment for more than 760,000 people believed to have been fraudulently signed up for Obamacare plans, an effort estimated to save $2.2 billion; Oz said at the October 14 press conference that Wednesday's action is separate from the one announced last month.
图片来源：图：美国卫生与公众服务部总部休伯特·汉弗莱大楼（华盛顿，资料图）。Gunnar Klack／Wikimedia Commons，CC BY-SA 4.0
