Patient Protection and Affordable Care Act; Temporary Moratoria on Certain Agent and Broker Registration To Participate in the Exchanges
Key claim: HHS is immediately freezing new agent and broker registrations for the federal health insurance marketplace through February 1, 2027, so only those already signed up for 2026 can enroll people while CMS tightens anti-fraud controls.
Abstract
(Rule · Health and Human Services Department) This interim final rule with comment period (IFC) codifies the Department of Health and Human Services’ (HHS) authority to impose a temporary moratorium pausing the registration of agents and brokers that do not have a current Plan Year registration with the Federally- facilitated Exchanges at the time the moratorium is effective and are seeking to enter into Exchange agreements with the Centers for Medicare & Medicaid Services (CMS) to assist consumers with enrollment through the Federally-facilitated Exchange (FFE) and State-based Exchanges that use the Federal platform (SBE-FPs) (hereinafter collectively referred to as the “Federally-facilitated Exchanges”). HHS is issuing this rule on an interim final basis. For the reasons explained in this rule, HHS finds good cause under the Administrative Procedure Act (APA) to waive prior notice and comment because providing advance notice would be contrary to the public interest and impracticable. HHS further finds good cause under the APA for this rule to become effective immediately upon publication. HHS nevertheless invites public comment and will consider comments in determining whether to retain, modify, or rescind the codified authority established by this rule. Further, CMS provides notice that, on behalf of HHS, the agency is immediately imposing a temporary moratorium to pause the registration of agents and brokers that do not have Plan Year 2026 Exchange agreements with the Federally- facilitated Exchanges and are seeking to enter into agreements with CMS to assist consumers with enrollment through the Federally-facilitated Exchanges for Plan Year 2027. This temporary moratorium does not affect registrations on the State-based Exchanges (SBEs). This moratorium will be in place while CMS implements enhanced program-integrity safeguards designed to prevent instances of noncompliance and fraud, waste, and abuse perpetrated by agents and brokers, including unauthorized enrollment activity, misuse of consumer personally identifiable information (PII), and other conduct that does not comply with Exchange standards and threatens consumers and the integrity of the Federally- facilitated Exchanges. Agents and brokers that do not have Plan Year 2026 Exchange agreements with CMS will not be able to complete registration with the Federally-facilitated Exchanges for Plan Year 2027 until the moratorium ends on February 1, 2027.
Why this matters
Agents and brokers are the primary enrollment channel for a large share of HealthCare.gov consumers, and CMS has been battling a surge of unauthorized plan-switching fraud attributed to bad actors in that channel. Freezing new registrations until February 2027 narrows the pool of people who can enroll consumers in Federally-facilitated Exchange coverage, which affects enrollment capacity even though plan benefits, premiums, and subsidies are unchanged.