CMS Cancels 760,000 ACA Enrollments

PHOTO CAPTION: Vice President JD Vance and Centers for Medicare and Medicaid Services Administrator Mehmet Oz discuss federal health care fraud enforcement during a White House press conference on Sept. 22, 2026. CMS says it canceled approximately 315,000 Affordable Care Act Marketplace enrollments covering more than 760,000 people and expects about $2.2 billion in associated premium tax credit payments to be returned. (White House video)

The federal government canceled Affordable Care Act Marketplace enrollments covering more than 760,000 people after determining the enrollments were unauthorized, part of a wider crackdown involving insurance brokers, eligibility verification and billions of dollars in federal subsidies.

The Centers for Medicare and Medicaid Services disclosed Tuesday that it canceled approximately 315,000 enrollments covering more than 760,000 individuals on Aug. 31.

CMS says it expects the cancellations to result in the return of approximately $2.2 billion in advance premium tax credit payments associated with those policies.

The federal rulemaking documents provide additional detail about what triggered the action.

According to CMS, the canceled policies involved people enrolled with assistance from agents or brokers who did not have verified citizenship or immigration documentation.

The agency also said insurance companies were unable to identify claims or establish contact with the consumers involved.

CMS says its review with health insurers ultimately determined that the enrollments were unauthorized.

That does not necessarily mean every person whose coverage was canceled personally committed fraud.

CMS says some of the problems it has identified across the Marketplace involve agents or brokers enrolling people without their genuine consent, changing coverage without permission, supplying inaccurate information or creating questionable applications in order to receive commissions.

Those practices can result in federal subsidies being paid for coverage that a consumer did not request or may not have been eligible to receive.

The crackdown extends to the brokers who help consumers enroll.

Since January, CMS says it has sent termination notices to more than 200 agents and brokers it determined were not complying with Marketplace rules.

During July and August, the agency also issued 569 notices of intent to terminate Exchange agreements involving agents and brokers whose 2026 applications showed what CMS called statistically implausible patterns.

Those applications frequently lacked identifying information such as Social Security numbers.

CMS says the group showed substantially higher rates of several problems than agents and brokers who had been registered before 2026.

Their applications were 2.8 times more likely to have unresolved income verification problems, 2.7 times more likely to lack Social Security numbers and 2.6 times more likely to have unresolved citizenship or immigration verification issues.

They were also more likely to involve unresolved Medicaid issues and certain special enrollment periods.

The agency is going further for the upcoming enrollment year.

CMS has temporarily stopped agents and brokers who do not already have an active 2026 Exchange agreement from newly registering for the 2027 federal Marketplace.

That moratorium is scheduled to remain in effect until Feb. 1, 2027, unless officials end it sooner.

CMS is also requiring existing agents and brokers to prove their identities again through Login.gov or ID.me.

Applications involving brokers will have to include Social Security numbers or immigration document numbers for non newborn applicants, and consumers will have to provide electronic authorization before an agent or broker can act on an application or enrollment.

Vice President JD Vance, who chairs the White House Task Force to Eliminate Fraud, presented the cancellations Tuesday as part of the administration's broader effort to prevent federal health care money from going to unauthorized or ineligible enrollments.

CMS Administrator Mehmet Oz appeared with Vance during the announcement.

Insurance industry representatives support action against fraudulent enrollments but have criticized the broader restriction on new brokers.

The National Association of Benefits and Insurance Professionals said fraudulent and unauthorized enrollments should be targeted directly rather than restricting legitimate licensed professionals.

The group argues that many consumers rely on agents to understand Marketplace plans and complete enrollment.

That concern is significant because brokers are heavily involved in the federal Marketplace.

The association says agents and brokers assisted with 76 percent of active HealthCare.gov plan selections during the 2026 open enrollment period.

CMS argues that the scope of the unauthorized enrollment problem requires stronger controls.

The agency estimates that improper federal spending connected with unauthorized Marketplace enrollments could total as much as $6.6 billion for the 2026 plan year, depending on the methodology used.

For the more than 760,000 people covered by the enrollments canceled in August, however, the immediate consequence has already occurred.

Their Marketplace policies were canceled.

For taxpayers, CMS says roughly $2.2 billion in associated premium tax credit payments should be returned.

And for the agents and brokers who help millions of Americans navigate the Marketplace, the federal government is imposing new verification requirements while temporarily shutting the door to many new registrations.

(Source: OAF Nation)