What did CMS change for agents who enroll people in 2027 Marketplace plans?
CMS announced the changes on September 22, 2026 for the federal Marketplace, which HealthCare.gov runs. They apply to the agents and brokers who help people enroll, so most of what changes for you is what an agent asks you for.
| What CMS did | What it means when you enroll |
|---|---|
| Every existing agent and broker must re-prove their identity through Login.gov or ID.me | This applies to the agent. You do not need to do anything for it. |
| Applications involving an agent must include a Social Security number or immigration document number that CMS can verify for every applicant who is not a newborn | Have these numbers ready for each person who needs coverage. CMS has issued notices of intent to terminate agents whose applications lacked this information. |
| Agents cannot be added to applications that consumers should be completing on their own through HealthCare.gov | If you started your own application, CMS says the system now prevents an agent from being added to it. |
| Electronic consumer authorization is required before an agent or broker can act on an application or enrollment | CMS said it would put this in place before open enrollment. Ask your agent how you will approve their work, and approve only an agent you chose. |
| A temporary moratorium on new registration for 2027 for agents and brokers without an active Exchange Agreement for 2026 | CMS announced it in an interim final rule. An agent who did not have an active agreement for 2026 may not be allowed to register for 2027. |
Why did CMS make these changes?
CMS says it found a pattern of unauthorized enrollments and suspicious agent and broker activity in the federal Marketplace. KFF reports that the cancellation process likely caused some legitimately enrolled people to lose coverage, so we show both statements.
| Who | What they say |
|---|---|
| CMS | On August 31, 2026 it canceled approximately 315,000 enrollments covering more than 760,000 individuals after confirming they were unauthorized, and expects about $2.2 billion in advance premium tax credits to be returned. Since January 2026 it has sent termination notices to over 200 non compliant agents and brokers. |
| CMS, on agents who submitted applications without applicant information | This summer it issued 569 notices of intent to terminate Exchange Agreements to agents and brokers whose 2026 applications lacked information such as a Social Security number. Of the first 100, 66 have received termination notices. The other 469 were still pending. |
| KFF | KFF reports that the administration says the 760,000 people were improperly enrolled and did not respond to a request for more information within 30 days. KFF says that process likely resulted in some legitimately enrolled consumers losing their coverage. |
- Unresolved income verification issues2.8 times
- Missing Social Security numbers2.7 times
- Unresolved citizenship or immigration status issues2.6 times
- Special enrollment periods without verification1.6 times
- Medicaid denial attestations1.4 times
- Enrolled in both Medicaid or CHIP and the Marketplace1.4 times
Source: CMS fact sheet, Federal Marketplace (FFE and SBE-FP) Anti-Fraud Actions (September 22, 2026)
How do I check that my coverage and my agent are legitimate?
Start with the government sites, not an ad. The FTC says scammers and dishonest businesses sometimes pay to appear at the top of search results and use web addresses that look like HealthCare.gov or Medicare.gov.
- Type HealthCare.gov into your browser yourself, or call 800-318-2596 to check your coverage. For Medicare, use Medicare.gov or call 800-633-4227.
- Scroll past results labeled Ad or Sponsored and look for the .gov ending.
- Because CMS now requires applicant numbers on agent applications, a real agent will ask for them. Give them only to an agent you chose to work with, not to a caller or an ad you did not look for.
- Ask for the agent's full name and license number, and confirm the license with your state's department of insurance before you share documents.
- If you get a plan notice or a coverage change you did not ask for, call 800-318-2596 right away.
- Report suspected scams at ReportFraud.ftc.gov. For Medicare scams, report at Medicare.gov or call 800-633-4227.
For free help comparing plans, the FTC points to HealthCare.gov and its Find Local Help tool for Marketplace plans, and to State Health Insurance Assistance Programs and Senior Medicare Patrol for Medicare.
What has CMS proposed for 2028?
On October 23, 2026 CMS proposed a rule that would require the Marketplace to verify certain information before it gives you premium help. It is a proposal, so it can change, and CMS says it would take effect with eligibility decisions for plan year 2028, not 2027.
| Proposal | What CMS says it would do |
|---|---|
| Verify before paying help | The Marketplace would verify household income and family size, citizenship or eligible immigration status, eligibility for other qualifying coverage and place of residence before it provides advance premium tax credits or cost sharing reductions. You could still enroll without financial assistance while checks are pending. |
| Early verification window | Starting August 1, 2027, each Marketplace would offer an optional window to submit eligibility information before open enrollment for the next coverage year. |
| Annual confirmation | People already enrolled would be re-enrolled with financial assistance only if they return to confirm certain eligibility information each year. Those who do not would be re-enrolled without financial assistance. |
| Contingent plan choice | You could select a plan that starts only if you are found eligible for financial assistance. |
| Public comment | People can comment for 30 days after the proposal is published in the Federal Register. |
KFF says the 2025 reconciliation law created pre enrollment verification requirements that could effectively end automatic renewal starting in 2028, which matches CMS's proposed start. CMS describes the proposal as applying to plan year 2028, not 2027.
What should I get ready before I enroll for 2027?
Open enrollment for 2027 coverage begins November 1, 2026. Choose a plan by December 15, 2026 for coverage that starts January 1, 2027.
- A Social Security number or immigration document number for every person who needs coverage, except newborns.
- A 2027 household income estimate. An honest estimate matters, because credits are based on it and you may have to repay extra credits at tax time.
- Your doctors and prescriptions, so the agent can check each plan's network and drug list.
- A phone or email you can use to approve your agent's work electronically.
How can an agent help, and do I pay extra?
A licensed agent can compare plans from several insurers side by side, check what help you qualify for and complete the application with you. Our guide on whether insurance agents cost extra explains how agents are paid.
Health Insurance Solutions agents are licensed in 22 states and help by phone and online. Marketplace plans cost the same with or without an agent, so the comparison does not add to your premium.
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