CMS kicks 760,000 people off ACA plans in crackdown on ‘unauthorized’ broker-supported enrollments
As part of what it calls a crackdown on fraud, waste and abuse in healthcare, the Centers for Medicare & Medicaid Services (CMS) is canceling “unauthorized enrollments” in Affordable Care Act (ACA) plans, leaving 760,000 people without medical insurance.
In an announcement made on Tuesday, the agency said it was canceling approximately 315,000 unauthorized enrollments covering more than 760,000 people who used the government marketplace to buy medical coverage, and many of those plans covered multiple people, possibly families.
CMS said the move would return $2.2 billion in subsidies back to federal coffers.
It’s not entirely clear what, if any, fraud the individual beneficiaries engaged in. But, in the same announcement, CMS said it had begun the process of kicking 569 agents and brokers off government marketplaces, issuing notices of intent to terminate over the summer. To date, 200 who were deemed non-compliant with federal regulations have been removed.
The agency added that applications the brokers submitted to cover their members lacked necessary documentation, such as Social Security numbers (SSNs).
The Secretary of the U.S. Department of Health and Human Services (HHS), Robert F. Kennedy Jr. framed all of the above as CMS “strengthening safeguards, pursuing bad actors, and holding agents and brokers accountable when they break the rules.”
“Under President Donald Trump, HHS will protect Americans’ health coverage and ensure taxpayer dollars reach the people they are intended to serve,” he added.
As for who these brokers are, CMS said many of them are brand new to the ACA marketplace, having first registered to participate in 2026. The agency said that new registrants represent an overall “small fraction of agent- and broker-assisted enrollments,” but a disproportionately large number of those deemed to be acting in a manner flagged as potentially fraudulent.
In an effort to “address the risk,” CMS stated that it will be releasing an Interim Final Rule that would bar new brokers from selling on the marketplace for a single year—that being 2027—meaning only those active in 2026 would be eligible to act as agents for enrollees.
“Every dollar lost to fraud is a dollar taken from hardworking taxpayers and the Americans these programs are intended to serve,” CMS Administrator Mehmet Oz, MD, said. “We are using our data, enforcement authorities, and stronger safeguards to identify fraud and abuse, stop it, and recover taxpayer dollars. We are making sure Americans—not bad actors—remain in control of their health coverage.”
A proactive audit
CMS is also taking a closer look at the agents and brokers who remain on the market, requiring all of them to re-identify themselves using Login.gov or ID.me. They are also asking that documentation on members be checked for accuracy and include immigration document numbers or SSNs.
Systems will also be updated to flag incidents where ACA enrollees should be filling out paperwork on their own, without the assistance of an agent, in an effort to cut down on brokers being added to applications unnecessarily.
For more, read the full announcement from CMS by clicking here.
Chad is an award-winning writer and editor with over 15 years of experience working in media. He has a decade-long professional background in healthcare, working as a writer and in public relations.