ACA enrollment opens with new ID checks and fewer brokers

Open enrollment for Affordable Care Act health insurance coverage for 2027 begins Nov. 1 in most states. The new rules introduce tighter identity checks for consumers who use brokers and a temporary freeze on agents new to the federal marketplace. These changes aim to reduce fraud but may slow down the sign-up process for millions of shoppers.

Enrollment began earlier in Idaho, Connecticut, and Massachusetts. Many states have allowed consumers to check premium rates ahead of the official start date. Analysts expect overall enrollment to decline because the enhanced subsidies that lowered costs expired at the end of 2025. The Trump administration credits its anti-fraud efforts for the drop, including the August cancellation of policies for 760,000 enrollees suspected of improper sign-ups.

The Centers for Medicare & Medicaid Services issued new rules targeting fraud in the federal marketplace, which serves 29 states. Consumers using an agent must now receive a one-time confirmation code or link via text, email, or phone call to authorize that specific agent to act on their behalf. Returning customers with outdated contact information must update it directly through the federal marketplace before using an agent.

CMS classifies certain applicants as high-risk, requiring them to verify their identity before authorizing an agent. This group includes first-time applicants, people changing states, those switching to a new agent, and consumers with monthly premiums of $30 or less. Identity verification is handled by third-party firms like Experian, which asks questions only the consumer should know. Those who fail may need to submit documents like a driver's license or passport directly to healthcare.gov.

Joshua Brooker, an insurance agency owner in Pennsylvania, noted that moving between states or brokers can mimic the behavior of fraudulent agents. He estimated that up to one in five consumers may face extra identity proofing, which could cause some to give up on getting insured. Stacey Pogue, a senior research fellow at Georgetown University, said the measures target fraud but may create hurdles for people without established credit files or those who have changed names.

A separate rule issued in September places a moratorium on brokers who are new to offering ACA coverage. Agents not registered with the federal marketplace in 2026 cannot assist with 2027 enrollments until February, which is after the open enrollment period ends. CMS said this step addresses compliance concerns from newly registered agents and follows the removal of hundreds of non-compliant brokers this year.

Jason Fine, a Florida brokerage owner, said the rules make sense long term but create short-term chaos. He planned to hire up to 10 agents but found it difficult to find candidates registered in 2026. He suggested the move benefits large call centers that can maintain year-round staff. Agent groups have pushed back, with the National Association of Benefits and Insurance Professionals filing a lawsuit on Oct. 15. Health Agents for America filed a separate suit on Oct. 21 seeking a temporary restraining order.

Premiums for 2027 are expected to rise by 15%, down from a 26% increase last year. Subsidies remain available but are less generous now that the enhanced subsidies have lapsed. Income-based subsidies cut off for households earning more than four times the federal poverty rate, which is $63,840 for a single person this season. The out-of-pocket maximum for individual plans will rise 13% to $12,000 in 2027, while family plans will see a cap of $24,000.

New laws also strip subsidy eligibility from many lawfully present immigrants, including H-1B visa holders, refugees, and asylees. Green-card holders and citizens of Micronesia, the Marshall Islands, or Palau retain eligibility. Experts advise consumers not to let plans auto-renew but to compare premiums, deductibles, and coverage changes, as some insurers like Cigna have exited certain markets.