The Centers for Medicare & Medicaid Services (CMS) has paused registration of new insurance agents and brokers on the federal health insurance marketplace, effective September 22, 2026, and will keep the pause in place until February 1, 2027 unless it is lifted, extended or modified sooner. The measure, published in the Federal Register on September 23 as an interim final rule with comment period, targets a problem the agency describes as unauthorized enrollments and plan switches by commission-paid brokers.
What the rule does
The rule adds a new provision, 45 CFR 155.220(o), that gives the Department of Health and Human Services (HHS) authority to impose a temporary moratorium on registering agents and brokers who do not have a current-year registration with the Federally-facilitated Exchanges (the HealthCare.gov platform and the state-based exchanges that use it). CMS then used that authority immediately.
- Who is blocked: agents and brokers without a Plan Year 2026 Exchange agreement, meaning people who would be new entrants for Plan Year 2027.
- Who is not affected: agents and brokers already registered for 2026; web-brokers, which the rule says are outside its scope; and state-based exchanges that run their own platforms. Agents whose 2026 agreement was terminated or denied and later reversed or reinstated can still register during the pause.
- What it means in practice: affected agents cannot complete training, registration or the signing of Exchange agreements until the moratorium ends.
CMS notes that 84,012 registered agents and brokers had active enrollments in Plan Year 2026. The agency says it expects the returning workforce to give consumers adequate access to enrollment help during the 2027 open enrollment period.
What CMS says the data show
The agency’s case rests on complaint volumes and on a comparison between newly registered and longer-registered agents:
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- From 2023 through 2025, CMS received more than 624,000 consumer complaints of unauthorized enrollments or plan switching that were confirmed by issuer review, about 300,000 of them in 2025.
- In July 2026 CMS sent notices of intent to terminate to the top 100 agents and brokers by suspect enrollment activity, and in late August it sent 469 more, for 569 in total. The stated basis was potential violations of conduct standards, including statistically implausible rates of applications submitted without applicant identifiers such as Social Security numbers.
- Agents and brokers who first registered for 2026 made up roughly 11 percent of those with an active 2026 enrollment but about 30 percent of the 569 who received notices. CMS concludes they are about three times more likely to be noncompliant.
- Compared with earlier-registered agents, new entrants showed 2.8 times the rate of enrollments with unresolved income-verification data matching issues, 2.7 times the rate of enrollments without Social Security numbers, and 2.6 times the rate with unresolved citizenship or immigration verification issues.
- CMS reports 160 final terminations so far for Plan Year 2026 conduct, 11 percent of them newly registered agents.
The rule also cites Government Accountability Office reports and Justice Department cases involving enrollment fraud by brokerages.
What the evidence does and does not show
This is a regulatory finding, not a study, and several details deserve caution.
- The rule’s own text tempers the trend. CMS acknowledges that complaints rose in 2025 compared with 2024, but also that data from the start of 2026 already show a substantial decrease.
- The 30-percent share comes from enforcement targeting. Notices went to agents CMS flagged using its own screening criteria, so the comparison reflects who CMS selected for scrutiny, not a random sample.
- Financial estimates span a very wide range. CMS projects that the pause will prevent improper premium tax credit spending of roughly $48 million to $877 million a year. Those figures derive from baseline estimates of about $1.5 billion (low) and $6.6 billion (high) in improper spending. The high figure is built on the gap between on-exchange and off-exchange plans with zero claims in Plan Year 2024 (34 percent versus 23 percent), which the rule itself says may overstate fraud because other differences between the two markets could explain part of the gap. The low figure uses complaint counts as a proxy.
- Costs to the industry are also estimated. CMS expects reduced broker competition, possible operational and job losses for agencies that cannot register, and a transfer of roughly $71 million to $98 million in commission revenue to existing agents.
What remains unknown
- Whether the promised identity-proofing, consumer-authorization and monitoring controls will be ready by February 1, 2027, and whether the pause will be extended.
- How much the fall 2027 open enrollment experience changes for consumers who rely on brokers, particularly in areas with fewer agents.
- How CMS will weigh public comment. It says it will consider comments, due by November 21, 2026, in deciding whether to retain, modify or rescind the authority. It issued the rule without advance notice and comment, finding good cause under the Administrative Procedure Act.
- Whether the rule will draw legal challenges. The text does not address this, and none had been reported in the sources reviewed.
Why it matters
Brokers typically earn a monthly commission from insurers for each active enrollment, which CMS says can create an incentive to enroll people without their consent or to switch their plans. For consumers, CMS says the risk is losing desired coverage or having it changed inappropriately.
The rule also marks a shift in approach. Until now CMS relied on penalties applied after an agent was already registered; this move restricts entry before the new safeguards are in place. CMS says the framework is aligned with moratoria it already uses for newly enrolling Medicare providers and suppliers.
This article is general information, not legal, financial or medical advice.
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