US pauses new ACA agent and broker sign-ups to curb enrollment fraud

The federal government has frozen new agent and broker registrations with the Affordable Care Act's federal insurance marketplaces, part of an effort to stem a surge in enrolments made without consumers' knowledge or consent. An interim final rule from the Department of Health and Human Services, published in the Federal Register on 23 September 2026 and effective 22 September 2026, codifies HHS's authority to impose such a moratorium [s1].

Alongside the rule, the Centers for Medicare & Medicaid Services immediately imposed one. The pause blocks agents and brokers that do not already hold a Plan Year 2026 Exchange agreement from completing registration to sell Plan Year 2027 coverage through the Federally-facilitated Exchanges until the moratorium ends on 1 February 2027 [s1]. It does not affect registrations on State-based Exchanges that run their own platforms [s1].

The problem the rule is responding to

CMS says it has seen a substantial rise in unauthorised enrolments, unauthorised plan switching and other non-compliant conduct by newly registered agents and brokers on the federal platform [s1]. The rule puts numbers to that claim. From January through August 2024, CMS received 90,863 complaints that consumers had their marketplace plan changed without their consent [s1]. In total the agency logged about 624,000 consumer complaints tied to unauthorised activity confirmed by issuer review, roughly 300,000 of them in 2025 alone [s1].

An independent tally points the same way. A Government Accountability Office report from July 2026 found 299,604 consumer complaints tied to confirmed unauthorised enrolments and plan switches on the federal platform in 2025 [s1]. CMS also notes that more than 550,000 enrollees had their advance premium tax credit ended in 2025 after the agency identified concurrent enrolments in HealthCare.gov states — a marker of duplicate or improper sign-ups [s1].

The agency offers one more indirect measure. Plans bought on the federal platform were more likely than unsubsidised, off-Exchange plans to go an entire year with no claims filed — 34 percent versus 23 percent in Plan Year 2024, an 11-percentage-point gap [s1]. Zero utilisation is not by itself proof of fraud, since healthy people may file no claims, but CMS treats the differential as a possible signal of people enrolled in coverage they never asked for and therefore never used [s1].

The financial stakes are not hypothetical. The rule cites a Justice Department settlement in which National Partnership Insurance Brokers and a former subsidiary agreed to pay more than $135 million to resolve an ACA enrolment fraud scheme [s2].

How the pause works

The moratorium is narrowly drawn. It applies to agents and brokers seeking to enter new agreements with CMS for the 2027 plan year who lack a current, 2026 plan-year agreement; those already in good standing are unaffected and can continue to help consumers enrol [s1]. CMS frames the pause as a window in which it can stand up "enhanced program-integrity safeguards" designed to prevent unauthorised enrolment, misuse of consumers' personally identifiable information, and other conduct that fails Exchange standards [s1].

HHS invoked the Administrative Procedure Act's "good cause" provisions to skip advance notice and comment and to make the rule effective immediately, arguing that giving advance warning would be impracticable and contrary to the public interest — in effect, that announcing the freeze ahead of time would let bad actors rush to register before it took hold [s1]. The agency is nonetheless taking comment, due by 21 November 2026, on whether to keep, change or withdraw the codified authority [s1].

What is settled and what is not

What is fixed is the mechanism and the dates: a codified power to freeze registration, a pause in force from 22 September 2026 until 1 February 2027, and a comment period running to 21 November [s1]. The underlying ability of consumers to enrol, and of already-registered agents to assist them, is not suspended [s1].

What is less settled is the trade-off. A registration freeze is a blunt instrument: it can shut out legitimate new agents alongside fraudulent ones, and the rule's own evidence — complaint counts, zero-utilisation gaps, a GAO estimate — is circumstantial rather than a direct measure of how many enrolments were fraudulent [s1]. Because HHS bypassed notice-and-comment on a good-cause basis, the rule may also draw procedural challenges even as the agency collects comment after the fact [s1]. For now, the concrete facts are the ones the government has put on the record: hundreds of thousands of complaints, a nine-figure fraud settlement, and a four-month pause on new federal-marketplace registrations [s1][s2].

Sources

• [s1] Patient Protection and Affordable Care Act; Temporary Moratoria on Certain Agent and Broker Registration With the Federally-Facilitated Exchanges — Department of Health and Human Services / Centers for Medicare & Medicaid Services (Federal Register), 23 September 2026.
• [s2] National Partnership Insurance Brokers and Its Former Subsidiary Agree to Pay Over $135 Million For Affordable Care Act Enrollment Fraud Scheme — U.S. Department of Justice, Office of Public Affairs.