CMS Cancels 315K Enrollments to Recover $2.2B
The Centers for Medicare & Medicaid Services canceled about 315,000 federal Affordable Care Act marketplace enrollments covering over 760,000 individuals after determining they were unauthorized, the agency announced on September 22. CMS expects to recover approximately $2.2 billion in taxpayer-funded subsidies through these cancellations. The agency acted following reviews conducted by CMS and health insurers, according to an agency fact sheet.
The cancellations took effect on August 31, targeting advance payments of premium tax credits linked to those enrollments. While CMS did not specify the wrongdoers, it said it would hold agents and brokers accountable. “CMS is strengthening safeguards, pursuing bad actors, and holding agents and brokers accountable when they break the rules,” Health and Human Services Secretary Robert F. Kennedy Jr. stated in the announcement.
To strengthen oversight, CMS imposed a temporary registration moratorium for agents and brokers seeking participation in the 2027 federal marketplace who lack a 2026 exchange agreement. This pause remains in effect until February 1, 2027, unless CMS modifies or extends it. Existing agents and brokers must now reverify their identities through Login.gov or ID.me. New applications require verifiable Social Security or immigration documentation for applicants other than newborns. Before open enrollment, CMS will mandate electronic consumer authorization before agents or brokers can process applications or enrollments.
Since January, CMS has issued termination notices to over 200 agents and brokers for failing to comply with requirements. Additionally, the agency sent 569 notices of intent to terminate this summer due to missing identification details in applications. Of the first 100 cases reviewed, 66 resulted in termination notices. The enforcement actions include recovering past subsidy payments and stopping future payments for unauthorized enrollments. CMS will continue working with insurers to investigate questionable enrollments and cancel those confirmed as unauthorized.
The National Association of Benefits and Insurance Professionals raised concerns about the measures, saying the immediate changes came without an advance public comment period or meaningful notice ahead of open enrollment. The association supports targeted enforcement and stronger verification requirements but warned that restricting registrations could reduce consumers’ access to enrollment assistance. “We can protect program integrity while also protecting eligible consumers and their access to trusted, licensed professionals,” NABIP President Mychal Walker said in a statement.
A July Government Accountability Office report highlighted weaknesses in CMS’s verification processes, noting a rise in confirmed complaints about unauthorized enrollments and plan switches—from 66,548 in 2023 to 299,604 in 2025. The GAO identified gaps in consumer consent verification and notification procedures. In June, CMS strengthened rules to combat improper ACA enrollments, and in July 2024, it restricted broker access to HealthCare.gov enrollments.
Agents not already associated with an enrollment were required to take additional steps, such as joining a three-way call with the consumer and the Marketplace Call Center, before making changes. More stories like this: CMS blocks 11 suppliers over $3.4B in suspected fraud CMS blocks private sector enrollment sites from ACA marketplace CMS finalizes new rule to safeguard Affordable Care Act coverage.
