ACA Enrollment: New ID checks and broker limits complicate 2027 insurance shopping
Open enrollment begins with stricter verification rules, a freeze on new agents, and premium hikes as enhanced subsidies expire.
By Ricardo Alvarez ·
The Centers for Medicare & Medicaid Services has introduced new identity verification procedures and restrictions for agents assisting consumers with Affordable Care Act coverage. These changes take effect as open enrollment for 2027 coverage begins. Shoppers in most states can start the process on Nov. 1, while Massachusetts, Connecticut, and Idaho began earlier this month.
The federal marketplace, which serves 29 states, is tightening its rules to combat fraud. Consumers using agents or brokers must now obtain a one-time confirmation code to authorize a specific agent. Those classified as high-risk, including first-time applicants and individuals switching agents, must verify their identity through a third party like Experian. Joshua Brooker, an insurance agency owner in Pennsylvania, noted that this scrutiny aims to stop brokers from impersonating consumers.
The definition of high-risk also includes consumers with monthly premiums of $30 or less. Brooker suggested this cutoff targets plans where policyholders might not receive a bill, making them easier for bad agents to manipulate. He expressed concern that up to one in five consumers might face extra identity proofing, potentially causing some to drop out of the market. Stacey Pogue, a senior research fellow at Georgetown University, warned that these hurdles might affect people without established credit files or those who have recently changed their names.
A September rule from CMS places 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. Jason Fine, a Florida brokerage owner, said this move will make it difficult for small agencies to staff up for the season. He noted that larger call centers, which can maintain year-round staffs, may benefit from the shortage of available new agents. Two agent groups filed lawsuits on Oct. 15 and Oct. 21, arguing the moratorium unfairly targets approximately 19,000 new agents.
Premium costs remain a central concern for shoppers. Last year, the average premium increase was 26%, the largest in recent years. For 2027, premiums are slated to rise by 15%. While enhanced subsidies expired at the end of 2025, most buyers will still receive some financial assistance based on the cost of benchmark silver-tier plans. Louise Norris, a health policy analyst, stated that overall affordability will likely remain stable for those who managed costs this year.
Subsidy eligibility is income-based and cuts off for households earning more than four times the federal poverty rate. For a single person, that threshold is $63,840. For a family of three, it is $109,280. The One Big Beautiful Bill Act also removed subsidy eligibility for many lawfully present immigrants, including H-1B visa holders and refugees. Green-card holders and citizens of certain Pacific Islands retain access to subsidies.
Experts advise consumers to review their options rather than allowing plans to auto-renew. Out-of-pocket maximums, which cap the amount a consumer pays for medical costs, will increase by 13% in 2027. The limit for individual plans will rise to $12,000, while family coverage will reach $24,000. Anne Petry, an insurance owner in Illinois, described affordability as the biggest issue facing consumers this season. She urged shoppers to compare deductibles and coverage details, noting that some insurers have exited certain markets.
