For insurance agents and brokers, agencies that enroll consumers in Affordable Care Act marketplace plans, and the health plans that rely on them, registration rules determine how many people can be enrolled during open enrollment.
When regulators restrict who may register, the effects reach staffing, enrollment capacity, and compliance planning.
In “Insurance Lobby Decries ‘One-Two Punch’ Of CMS Moratorium,” Law360 Healthcare Authority examined the Centers for Medicare & Medicaid Services (CMS) interim final rule that bars new agents and brokers from registering for the 2027 plan year, along with the lawsuits insurance trade groups have filed to challenge it. George B. Breen, Member of the Firm of Epstein Becker Green and counsel to health insurers, health systems, and providers on government investigations and regulatory enforcement, commented on the rule.
The article reports that CMS describes the pause as a temporary measure tied to unauthorized enrollments. Agencies, meanwhile, point to about 19,000 prospective agents who may be kept out as open enrollment begins on Nov. 1. George said the rule will block eligible brokers, agents, and consumers from participating without any indication they have done anything wrong. He added that the government has other tools to address the small number of people committing fraud in the ACA market, and he questioned whether the rule fits the problem it targets.
"It's taking a hammer to a situation where a scalpel is probably the better tool to utilize," Breen said.
Get in Touch
To discuss how the registration moratorium and related CMS enforcement activity may affect your agency’s, brokerage’s, or health plan’s marketplace enrollment operations and compliance obligations, contact George Breen at gbreen@ebglaw.com.
