ACA Enrollment Shifts to Stricter ID Checks and Fewer Brokers

Open enrollment for Affordable Care Act coverage begins November 1 in most states, bringing a set of new rules that could slow down the sign-up process. The changes include stricter identity checks for consumers and a temporary freeze on new brokers. These moves follow a sharp drop in enrollment after enhanced subsidies expired at the end of 2025.

The Centers for Medicare & Medicaid Services introduced new requirements for people using agents or brokers in the federal marketplace. This affects consumers in the 29 states served by the federal platform. Returning customers with outdated contact information must update their records online or by phone before an agent can act on their behalf.

Applicants deemed high-risk must verify their identity through third-party services like Experian. CMS defines high-risk groups as first-time applicants, those moving states, and anyone with a monthly premium of $30 or less. Joshua Brooker, a Pennsylvania insurance agency owner, noted that these groups were targeted because switching states or brokers is a common method for impersonating consumers.

A September CMS rule also pauses the ability for new brokers to assist with 2027 enrollments until February. The agency cited a high number of compliance concerns from newly registered agents. Jason Fine, a Florida brokerage owner, said the move benefits large call centers that can maintain year-round staff, while small agencies struggle to find available agents.

Agent groups have pushed back legally. The National Association of Benefits and Insurance Professionals filed a lawsuit on October 15 against the administration. Ronnell Nolan, president of Health Agents for America, filed for a temporary restraining order on October 21. Nolan argued that new status does not imply fraud.

Premiums for 2027 are expected to rise by 15%, slightly lower than the 26% increase last year. Subsidies remain available for households earning below four times the federal poverty level, which is $63,840 for a single person. The out-of-pocket maximum for individual plans will increase to $12,000, and the family maximum will reach $24,000.

The One Big Beautiful Bill Act limits subsidy eligibility for many immigrants. Only green-card holders, specific Cuban and Haitian immigrants, and citizens of Micronesia, the Marshall Islands, or Palau remain eligible. Experts advise consumers to compare plans rather than allowing automatic renewal, as coverage costs and deductibles change annually.