The Trump administration plans to cancel enrollment in Affordable Care Act plans for more than 760,000 people as part of its crackdown on fraud, waste and abuse.
The Centers for Medicare & Medicaid Services announced on Tuesday that it would cancel 315,000 "unauthorized enrollments" covering that population, a move the agency said will return $2.2 billion in taxpayer funds from premium subsidies.
In addition, CMS said it will terminate more than 200 agents and brokers that have failed to comply with enrollment standards for the ACA's marketplaces. It submitted 569 notices of intent to terminate to brokers and agents over the summer after identifying that they submitted applications for 2026 coverage that lacked key information about the enrollee, such as Social Security numbers.
The agency said that while brokers and agents first registering for the 2026 plan year represent a small group in the broader landscape, they're overrepresented in submitted inappropriate enrollments and engaging in other "high risk" behavior.
As such, CMS said it will issue an interim final rule that instates a temporary moratorium on new registrations for brokers or agents in the 2027 plan year that did not have an active agreement for 2026.
"CMS is strengthening safeguards, pursuing bad actors, and holding agents and brokers accountable when they break the rules," Department of Health and Human Services Secretary Robert F. Kennedy, Jr. said in the announcement. "Under President Trump, HHS will protect Americans’ health coverage and ensure taxpayer dollars reach the people they are intended to serve."
The interim rule will also require existing brokers and agents to re-identify themselves through federal channels, and bars them from being added to applications that consumers should be completing for themselves. The rule will also require consumers to electronically authorize any agent or broker activity on their behalf.
CMS said that it established an anti-fraud coordination group for the federal insurance exchange that combines leaders from across CMS and HHS, which will meet regularly coordinate fraud enforcement and prevention efforts. The goal is "to drive a unified, sustained response to fraud" in the federal exchanges.
The agency said that Tuesday's announcement falls within its "three-pronged strategy" to mitigate fraud on the ACA marketplaces, including preventing fraudulent enrollments, eliminating improper enrollments that do go through and strengthening oversight of brokers and agents.
“Every dollar lost to fraud is a dollar taken from hardworking taxpayers and the Americans these programs are intended to serve,” said CMS Administrator Mehmet Oz, M.D., in the release. “We are using our data, enforcement authorities, and stronger safeguards to identify fraud and abuse, stop it, and recover taxpayer dollars. We are making sure Americans—not bad actors—remain in control of their health coverage.”
In a statement, David Merritt, senior vice president of external affairs for the Blue Cross Blue Shield Association, said the organization has "long advocated for enhanced eligibility verification, stronger oversight of agents and brokers, and other program integrity measures that help ensure Marketplace coverage reaches those who are eligible."
“The individual marketplace remains one of the most important pathways to comprehensive coverage for millions of Americans—especially for those who don’t have access to employer-provided coverage," Merritt said.
"We know that the marketplace needs to work for the people who depend on it and the taxpayers who support it," he continued. "That's why Blue Cross and Blue Shield companies have consistently supported stronger safeguards to make sure care is going to the people who need it most."