ACA shoppers face ID checks and premium hikes as enrollment opens

The 2027 open enrollment period for Affordable Care Act health insurance began on November 1 in most states, introducing stricter identity checks and higher costs for consumers. Idaho, Connecticut, and Massachusetts started their enrollment windows earlier this month. These changes coincide with a drop in overall enrollment following the expiration of enhanced subsidies at the end of 2025. The Trump administration views the decline in enrollment as a result of its efforts to reduce fraud, including the August cancellation of policies for 760,000 individuals suspected of improper sign-ups.

The Centers for Medicare and Medicaid Services implemented new rules affecting consumers who use agents or brokers on the federal marketplace. These rules apply to the 29 states served by the federal exchange but do not affect state-based exchanges. All consumers using an agent must now receive a one-time confirmation code or link via text, email, or automated phone call to authorize that specific agent. Consumers with outdated contact information must first update their records through the federal marketplace website or by phone.

Consumers classified as high-risk must verify their identity through a third party such as Experian before authorizing an agent. CMS defines high-risk applicants as first-time enrollees, those changing states, those using a new agent, or those with monthly premiums of $30 or less. Joshua Brooker, who owns an insurance agency in Pennsylvania, noted that the $30 threshold likely targets plans where policyholders might not receive bills, allowing rogue agents to pay premiums themselves while collecting commissions. Brooker estimated that up to one in five consumers may now face extra identity proofing, which could cause some to abandon the enrollment process.

A September CMS rule 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 at least February. This decision follows a review of compliance concerns, with CMS stating that a disproportionate number of issues came from newly registered agents. The agency also removed hundreds of non-compliant agents and brokers during the current year. Jason Fine, a Florida brokerage owner, said the rule makes it difficult for small agencies to hire temporary staff, as many available agents are new registrants who cannot work until after the open enrollment season ends.

Premium costs remain a primary concern for shoppers. While most consumers will still receive subsidies, the amounts are less generous than during the enhanced subsidy period that expired in 2025. Last year, average premiums increased by 26%, the largest jump in years, driven by insurer concerns about healthy individuals leaving the marketplace. For 2027, premiums are expected to rise by 15%. Subsidies are income-based and end for households earning more than four times the federal poverty level, which is $63,840 for a single person and $109,280 for a family of three.

The One Big Beautiful Bill Act passed by Congress last year also restricts subsidy eligibility for many lawfully present immigrants. Groups such as H-1B visa holders, refugees, and those with pending green-card applications are no longer eligible. Green-card holders, certain Cuban and Haitian immigrants, and citizens of Micronesia, the Marshall Islands, or Palau retain eligibility. Experts advise consumers to compare plans rather than allowing policies to auto-renew, as out-of-pocket maximums are rising. For 2027, the individual out-of-pocket maximum will increase by 13% to $12,000, and the family maximum will rise to $24,000.