What CMS Did on September 22, 2026

On September 22, 2026, CMS announced two simultaneous and sweeping actions targeting fraud in the ACA Marketplace:

Action 1 — Cancellation of 760,000+ Marketplace Enrollments

CMS cancelled approximately 315,000 ACA Marketplace enrollments covering more than 760,000 individuals. According to federal rulemaking records published September 23, these individuals enrolled with agent or broker assistance but lacked verified citizenship or immigration documentation at the time of enrollment. The cancellations took effect August 31, 2026 — meaning the coverage had already been terminated when the public announcement was made. CMS estimated that unauthorized enrollments could account for up to $6.6 billion in improper 2026 federal spending.

Action 2 — Temporary Moratorium on New FFE Broker Registrations

CMS simultaneously enacted a temporary moratorium — through an interim final rule effective immediately — that blocks new agent and broker registrations on the federally-facilitated exchange (FFE) for Plan Year 2027. The moratorium runs through February 1, 2027, unless CMS lifts, extends, or modifies it by notice. Only agents and brokers who do not already hold a Plan Year 2026 Exchange Agreement with the FFE are affected. The moratorium does not apply to state-based exchanges (SBEs).

Action 3 — Barring 569 Brokers and Ongoing Terminations

CMS announced it will bar approximately 569 brokers identified as submitting “statistically implausible” rates of Plan Year 2026 applications without the necessary consumer consent or documentation. Additionally, CMS had already issued termination notices to more than 200 noncompliant agents and brokers since January 2026 as part of its ongoing enforcement program.

Who Is Affected by the Broker Moratorium — and Who Is Not

The most important practical question for ACA brokers is whether the moratorium affects their ability to sell during OEP 2027. The answer depends on one factor: whether you already hold a Plan Year 2026 Exchange Agreement with the FFE.

If you are an established ACA broker who was actively registered and selling on Healthcare.gov in 2026, the moratorium does not block your participation in OEP 2027. You can continue to assist clients in selecting and enrolling in Marketplace plans for 2027 coverage on the FFE — provided your existing registration and compliance standing remain in good order. The moratorium is specifically targeted at preventing new, unvetted broker registrations during the lead-up to open enrollment.

Why CMS Acted: The Fraud Pattern Behind the Decision

CMS’s actions are the direct result of a documented pattern of fraudulent enrollment practices in the ACA Marketplace that accelerated during and after the COVID-era continuous enrollment protections. The core fraud pattern: bad-actor brokers — or organizations fraudulently acting as brokers — enrolled individuals in Marketplace plans without their knowledge or consent, often changing their existing plans to different carriers to generate enrollment commissions.

CMS identified that the 760,000 affected individuals enrolled with agent or broker help but lacked verified citizenship or immigration documentation. These enrollments generated premium tax credits funded by federal taxpayers — leading to CMS’s estimate of up to $6.6 billion in potentially improper 2026 federal spending across all identified fraudulent enrollment activity.

The 569 brokers being barred were specifically identified as having submitted statistically implausible application rates — meaning the volume and pattern of enrollments associated with their NPN (National Producer Number) was inconsistent with legitimate individual broker sales activity and was more consistent with bulk, unauthorized enrollment submission. This is distinct from legitimate high-volume producers whose enrollment patterns are consistent with their market presence.

Compliant ACA brokers who have been conducting business correctly — obtaining proper consumer consent, verifying client information, maintaining signed SOAs and permission documentation, and submitting enrollments only for clients who requested assistance — are not the targets of this enforcement action. The action is explicitly directed at fraudulent activity, not at legitimate broker participation in the Marketplace.

What Happens to the 760,000 People Whose Coverage Was Cancelled

The 760,000 individuals whose coverage was cancelled present a significant opportunity and responsibility for brokers. Many of these individuals may have been enrolled without their full knowledge or informed consent — they may not have understood what plan they were in or that their coverage was tied to a specific broker’s NPN. They are now uninsured and need assistance re-enrolling in legitimate ACA coverage for the remainder of 2026 and for 2027.

These individuals may be eligible for:

• A Special Enrollment Period (SEP) if they lost coverage involuntarily and qualify under a loss-of-coverage SEP trigger
• Medicaid or CHIP if their income qualifies
• New enrollment during OEP 2027 beginning November 1, 2026

For compliant ACA brokers, this creates a population of individuals who need professional assistance navigating their options — through proper, documented, consent-based broker support. The right broker response to this situation is proactive community outreach, clear explanation of available options, and fully documented enrollment assistance. Verify specific SEP eligibility criteria with Healthcare.gov or your FMO before advising clients on eligibility.

Impact on OEP 2027: What ACA Brokers Must Know Before November 1

The 2027 ACA Open Enrollment Period (OEP) begins November 1, 2026, and runs through January 15, 2027, with December 15, 2026 as the deadline for January 1, 2027 effective coverage. These dates are unchanged by the CMS actions. However, the enforcement context has changed dramatically, and every ACA broker must enter OEP 2027 with heightened compliance discipline.

Enhanced Verification Requirements Are Coming

The CMS actions signal that enhanced identity and eligibility verification requirements will be more actively enforced during OEP 2027. Brokers should expect stricter documentation requirements and heightened scrutiny of enrollment submissions. Documentation of client consent, identity verification, and eligibility confirmation is more important than ever going into this open enrollment period. Contact CMS or your FMO for the most current guidance on documentation standards for OEP 2027.

New Brokers Face a Delay — But Not a Permanent Bar

Agents and brokers who were not registered on the FFE for Plan Year 2026 cannot register on the FFE for Plan Year 2027 until February 1, 2027 — after OEP closes. This means new-to-FFE brokers who planned to sell Marketplace plans during OEP 2027 will need to serve those clients through already-registered colleagues, through state-based exchanges where applicable, or wait until the moratorium lifts. The moratorium is temporary and subject to modification by CMS notice. New brokers should monitor CMS announcements closely and work with an FMO for guidance on alternative pathways during the moratorium period.

State-Based Exchanges Are Not Affected

The moratorium applies only to the federally-facilitated exchange (Healthcare.gov). States that operate their own state-based exchanges (SBEs) — including California, New York, New Jersey, Connecticut, Massachusetts, Colorado, Washington, and others — are not subject to the federal moratorium. Brokers in SBE states should contact their state exchange for current registration and participation requirements for OEP 2027, as state exchanges may implement their own enhanced procedures in response to the federal action.

Broker Action Plan: Protecting Your Clients and Your Compliance Standing

The CMS actions create five specific tasks for every ACA broker before OEP 2027 opens November 1:

1. Confirm Your FFE Registration Status Today

Log into your Healthcare.gov broker/agent account and verify that your Plan Year 2026 Exchange Agreement is active and your registration is in good standing. If you have received any compliance communications from CMS, address them immediately. Do not assume your status is clear — verify it.

2. Review Your Consent and Documentation Practices

The central issue in the CMS fraud cases was enrollment without documented consumer consent. Going into OEP 2027, every enrollment you submit must be accompanied by documented, verifiable consumer consent. This means: signed written authorization or recorded verbal consent before submitting any enrollment, proper verification of the client’s identity and contact information, and retention of that documentation in your records. Review your current intake process with your FMO or compliance advisor and close any gaps before November 1.

3. Audit Your Existing Client Book for Unauthorized Changes

Contact every ACA client in your book and confirm that they are aware of their current plan, their current broker of record, and their current coverage status. If any client is surprised to learn what plan they are in or who holds their broker of record designation — that is a red flag that requires immediate investigation and correction. Clients should know who their broker is and have actively chosen to work with them.

4. Reach Out to Clients Whose Coverage May Have Been Cancelled

If any of your clients were among those whose coverage was cancelled effective August 31 — even if their original enrollment was legitimate but affected by the broad cancellation action — help them understand their options immediately. They may be able to re-enroll through an SEP or through OEP 2027 starting November 1. Work with your FMO or consult Healthcare.gov for current guidance on re-enrollment options for affected individuals.

5. Monitor CMS for Moratorium Updates Through OEP

CMS stated that the moratorium runs through February 1, 2027, “unless CMS lifts, extends, or modifies it by notice.” The situation is fluid. Monitor CMS.gov and your FMO communications daily for updates on the moratorium, enhanced verification requirements, and any changes to OEP 2027 broker participation rules.

How Affordable Care Agents Supports ACA Brokers Through Compliance Challenges

Affordable Care Agents is a national FMO and IMO that supports licensed ACA, Medicare, and ancillary insurance brokers nationwide. In response to the CMS actions, ACA is actively helping contracted brokers:

• Verify their FFE registration and Exchange Agreement status ahead of OEP 2027
• Review and strengthen their consent documentation and client intake processes
• Understand the moratorium’s specific impact on their ability to sell during OEP 2027
• Navigate alternative pathways for new-to-FFE brokers during the moratorium period
• Stay current on CMS guidance updates through the November 1 OEP open date and beyond
• Connect with compliance training resources to ensure fully documented, compliant enrollment practices

Frequently Asked Questions