Dive Brief:

• The CMS is pausing new broker registrations for the Affordable Care Act exchanges next year and terminating coverage for hundreds of thousands of Americans in an effort to crack down on fraud, the agency announced Tuesday.
• The moratorium, effective immediately through an interim final rule, means no new agents or brokers will be able to register to help consumers enroll in marketplace coverage during open enrollment beginning in November.
• The Trump administration also announced it was terminating ACA coverage for more than 760,000 people, saying their enrollment was unauthorized.

Dive Insight:

Brokers and agents are intermediaries to help people find and sign up for coverage. They largely work on commission from insurers, which creates a financial incentive to maximize enrollments.

Reports of broker misconduct in the ACA have been rampant in recent years, with instances of brokers switching enrollees from one plan to another without their permission or enrolling people in coverage without their consent.

Although new brokers comprise only 11% of all brokers, they accounted for 30% of all compliance-related terminations for the 2026 plan year, according to the CMS. They were also more likely to omit crucial details from applications, such as Social Security numbers, compared to established brokers, the agency said.

The CMS said it’s sent termination notices to more than 200 agents and brokers misusing the system since January.

The pause in new broker registrations, which is expected to last until Feb. 1 and applies to states using the HealthCare.gov platform, is meant to help the CMS improve safeguards and prevent an influx of bad actors in the exchanges.

The Trump administration and Republicans in Congress have been beating the drum about ACA fraud, pointing to research from a conservative think tank that millions of ACA members generate zero claims, allowing insurers to pocket tens of millions of dollars in subsidies for the “phantom enrollees.”

Health policy experts and the insurance industry dispute the scope of that report, though other research also suggests fraud exists, albeit on a smaller scale. And insurers generally support strengthening fraud protections — the CMS says it regularly partners with the industry to identify and cancel unauthorized enrollments.

"No amount of fraud is ever acceptable,” said Chris Bond, a spokesman for AHIP, a national trade association for the health insurance industry.

Still, the moratorium could reduce capacity during the upcoming open enrollment period. Legitimate brokers seeking to enter the market will be locked out for at least several months while CMS strengthens its vetting process.

Kevin Mayeux, CEO of the National Association of Insurance and Financial Advisors, a large trade group for insurance professionals, said that while she shares the CMS’ goal of slashing fraud, the group has “serious concerns” about the freeze on new registrations.

“A blanket moratorium on new registrations is a blunt and inappropriate response to a problem CMS admits is concentrated and not reflective of the wider industry,” Mayeux said. “That concerns us not just for this Open Enrollment Period, but for the future of the profession.”

Some advocates are concerned about the motives behind the fraud crackdown following a 13% decrease in ACA enrollment this year. The Trump administration attributes the dip to its anti-fraud efforts, but patient advocates say these efforts coincided with the expiration of more generous financial subsidies for coverage, which caused premiums to soar and priced many people out of their plans.

“Once again, the Trump administration is using alleged fraud accusations as a political smokescreen to double down on what they are actually doing: taking health coverage away from hundreds of thousands of people,” Anthony Wright, executive director of consumer advocacy group Families USA, said in a statement.

Brokers with active 2026 exchange agreements are not affected by the freeze, though the CMS announced additional measures to prevent misconduct Tuesday, including requiring all existing agents to re-verify their identities.

Additionally, the CMS stood up an anti-fraud group that convenes HHS leaders to “drive a unified, sustained response to fraud” in the marketplace. The group will meet regularly to bolster program integrity and facilitate enforcement, the CMS said.