CMS has barred new brokers, agents from registering to sell plans on the ACA marketplace

On Sept. 23, the federal government paused new brokers and agents from registering to sell plans on HealthCare.gov, a move it says is meant to curb fraud.

Specifically, brokers and agents who weren’t registered to sell 2026 Affordable Care Act plans can’t register for 2027 until Feb. 1, after the 2027 open enrollment period has ended.

The temporary moratorium comes alongside stressors like insurer market exits, premium increases, and stricter verification requirements. Due to this pause, the Department of Health and Human Services (HHS) estimates 19,000 fewer brokers and agents will be available when open enrollment starts on Nov. 1. Analysts told Healthcare Brew this could all add up to more uninsured patients.

Insurance trade association the National Association of Benefits and Insurance Professionals (NABIP) filed a lawsuit against HHS and CMS on Oct. 15, arguing, among other things, HHS didn’t provide a chance for public comment and that this action exceeds the agency’s authority. Another trade association, Health Agents for America, filed suit on Oct. 21, also claiming it exceeds HHS’s statutory authority.

The Centers for Medicare and Medicaid Services (CMS), in a Sept. 22 press release, said it announced this pause because newly registered brokers and agents allegedly had a disproportionately high rate of “unauthorized enrollments and other high-risk activity” in 2026.

In response to Healthcare Brew’s request for additional information, a CMS spokesperson said the agency does not comment on topics that are pending litigation.

Why it matters. Over the last several years, some brokers and agents have reportedly signed up or switched enrollees to different plans without their informed consent.

This summer, CMS warned 569 agents and brokers that it intended to terminate their exchange agreements because they had failed to include critical applicant information like social security numbers—a potential red flag for fraud. HHS estimates in its federal register notice of this rule that pausing registration could save $48 million to $877 million a year in costs associated with advanced premium tax credits and $280,000 to $1.1 million in costs to consumers.

NABIP President Mychal Walker said in a press release that he agrees fraud exists in the ACA marketplace, but the temporary ban is “an overbroad response that harms legitimate professionals and the consumers they serve.”

Aaron Bujnowski, managing director of management consulting firm Alvarez and Marsal, told Healthcare Brew over email that he also agrees fraud is a problem, but he’s concerned “some people could end up uninsured” without broker assistance with shopping and enrollment.

In 2026, 76% of the 10.8 million people who selected a plan on HealthCare.gov during open enrollment got assistance from an agent or broker, according to CMS data.

The uninsured population is already on the rise and is adding to mountains of unpaid medical debt due to hospitals and health systems.

Potential rise in off-exchange enrollments. Louise Norris, health policy analyst for independent health insurance guide healthinsurance.org, told Healthcare Brew that she thinks some brokerages could face staffing shortages as a result of this pause. HHS says in its federal register notice that the rule “could lead to potential operational losses for agencies and brokerages and potential job losses for the agents and brokers who do not have plan year 2026 exchange agreements.”

Another thing that “raises a little bit of an alarm” for Norris is that if brokers are unable to enroll people in federal marketplace plans, their only option to keep that customer is to enroll them in off-marketplace plans.

“Are they going to tell their clients, ‘I can’t help you; you need to go to a different broker,’ or are they going to try to get those clients enrolled in something outside the exchange?” Norris said.

Enrollees in off-marketplace plans aren’t eligible for subsidies or other cost-sharing reductions. And even though many off-marketplace plans are still ACA-compliant, some options like short-term plans or health sharing ministries are not, and the difference isn’t always clearly advertised.

Non-ACA compliant plans are also a headache for healthcare systems, which already spend a significant portion of their budget on billing and other administrative tasks, Healthcare Brew previously reported.

A KFF survey found 5% of people with ACA plans up to 2025 switched to off-marketplace individual coverage, and 9% of previous enrollees became uninsured.

The big picture. This pause is one of several efforts by HHS and CMS to reduce fraud, including the removal of 760,000 ACA enrollees for alleged improper enrollments. (KFF Health News reported earlier this month that some people’s coverage was wrongly terminated and later reinstated.)

This ban doesn’t apply to Washington, DC, or the 21 states that run their own state-based exchanges.