What is changing for 2027 coverage
Open enrollment for 2027 Affordable Care Act coverage began Nov. 1 in most states and runs through Jan. 15, according to NPR. Idaho, Connecticut and Massachusetts started earlier, and some states have let people "window shop" to see premium rates in advance.
NPR reports that shoppers should expect premium increases, possible extra identity checks, potential delays in reaching a broker, and new limits on which immigrants can receive subsidies. Overall enrollment is expected to keep declining, mainly because the enhanced subsidies expired at the end of 2025. Policy experts say that expiration led millions of people to drop or lose coverage in the first few months of this year.
The Trump administration views the falling enrollment as a success and credits its efforts to reduce fraud. Those efforts include the August cancellation of policies covering 760,000 enrollees who were suspected of being improperly signed up, NPR said. A small number of those people have since regained coverage.
Added identity checks for people who use agents
One of the biggest changes is closer scrutiny of both consumers and agents, aimed at stopping fraudulent or improper enrollments. The rules, outlined by the Centers for Medicare & Medicaid Services, apply only to people who use an agent or broker on the federal marketplace, which serves 29 states. State-based exchanges have their own rules and have mostly been more successful at preventing fraudulent sign-ups, according to NPR.
Every consumer using an agent on the federal marketplace will need a one-time confirmation code or link to authorize that agent to enroll them or change their coverage. It will arrive by text, email or automated phone call from the private enrollment platform the agent uses. Returning consumers with wrong or outdated contact details must first call the marketplace or update their information through an online application.
Consumers deemed "high-risk" face a further step: verifying their own identity before authorizing an agent. CMS defines that group as first-time applicants, people whose applications involve a change of state, people working with a new or different agent, and those with a monthly premium of $30 or less. Verification goes through a CMS-approved third party such as Experian, which generally asks questions only the consumer should be able to answer. People who fail may have to call a help desk or create a healthcare.gov account and upload identification such as a driver's license or passport.
Concerns about the new hurdles
Joshua Brooker, who oversees an insurance agency in Pennsylvania, said regulators likely singled out those groups because "someone who is moving to a new state or switching brokers — that could be a broker trying to impersonate a consumer." He said the low-premium threshold may reflect worries that plans with little or no monthly cost are easier targets, because the policyholder may never get a bill. Still, he worried "that up to 1 in 5 consumers is going to have to do extra identity proofing" and might give up on getting insured.
Stacey Pogue, a senior research fellow at Georgetown University's Center on Health Insurance Reforms, said: "Some people may have trouble not because they're not real, but because they don't have a credit file, or have moved, or have changed names." She said the changes might "be an appropriate response by CMS that targets fraudulent enrollments but might also create extra hurdles."
A freeze on new brokers and the legal challenges
In September, CMS issued a rule placing a moratorium on brokers new to offering ACA coverage. Agents not registered with the federal marketplace in 2026 cannot assist with 2027 enrollments until February at the earliest, after open enrollment ends. CMS said a disproportionate share of "significant compliance concerns" in 2026 involved newly registered agents. The agency has also removed "hundreds of non-compliant agents and brokers" this year, NPR reported.
Jason Fine, who runs a brokerage in Florida, supports the goal and has reported rogue agents who switched his clients' coverage without permission. "Everything they are doing in the long term makes sense," he said, but in the short term, "I don't know if they care about the chaos it will cause." He said small agencies, which usually shrink after open enrollment and rehire late in the year, may struggle to find staff. He suggested the policy could unintentionally favor large call centers.
Two agent groups have sued. The National Association of Benefits and Insurance Professionals filed a lawsuit Oct. 15, saying the moratorium unfairly targets 19,000 agents who may want to sell ACA plans. Health Agents for America filed on Oct. 21 seeking a temporary restraining order. Its president, Ronnell Nolan, said: "Just because you're a new agent doesn't mean you are fraudulent."
Subsidies and advice for shoppers
After Congress did not renew the enhanced subsidies, most people with ACA coverage saw their costs rise this year, and higher earners lost assistance entirely. Combined with double-digit premium increases, many people paid substantially more, NPR reported.
Most buyers for next year will still receive a subsidy, but it will be less generous than before the enhancements ended. Subsidies are tied to the cost of the benchmark plan, the second-lowest-price silver plan in an area. Louise Norris, a health policy analyst for HealthInsurance.org, said, "For most folks, overall affordability will stay about the same," adding, "That's not to say it's great."
Pogue advised against waiting to book help. With fewer agents available, appointment slots may fill faster. "I would reach out early," she said.
