CMS announced on September 22 the cancellation of Affordable Care Act (ACA) marketplace coverage for more than 760,000 people the agency classified as unauthorized enrollments, and on the same day the agency paused new agent and broker registrations on the federal platform through February 1, 2027. Both moves land five weeks before 2027 open enrollment begins on November 1, which puts your exchange membership, your risk adjustment position, and your broker channel in motion at the same time. If your organization runs exchange plans alongside Medicare Advantage, the timing also overlaps with an annual enrollment period opening October 15.
What CMS did and who the actions cover
According to CMS, the cancellations took effect August 31 and cover roughly 315,000 enrollments representing more than 760,000 individuals, identified through CMS and issuer review of applications submitted largely by agents and brokers without identifying information such as a Social Security number. The agency expects to recoup about $2.2 billion in advance premium tax credits (APTC), the subsidy CMS pays to issuers each month on an enrollee's behalf. Becker's reports a further group of enrollments now under additional verification of legal status and income, so the final count is still moving.
The broker action runs on a separate track. Under an interim final rule effective September 22, agents and brokers without an active plan year 2026 exchange agreement are barred from registering for plan year 2027 on HealthCare.gov or on state-based exchanges using the federal platform until February 1, 2027. The pause does not apply to fully state-based exchanges, web-brokers, or brokers already holding a 2026 agreement. CMS grounded the decision in its own data, which shows newly registered brokers make up about 11 percent of active brokers and about 30 percent of those receiving termination notices, and comments on the rule are due November 21, 2026.
Why the risk pool math changes
The ACA relies on a risk adjustment program run by the Department of Health and Human Services (HHS) to move money between issuers in each state market, based on how sick each issuer's enrolled population is compared with the state average. The program is budget neutral within a state, so when a large block of members leaves the market, the average itself shifts, and every issuer's position against the new average shifts too, including issuers who lost no members at all.
Insurers argue the members being removed skew healthy. Modern Healthcare reports health insurers say the anti-fraud push is cutting membership, reducing premium revenue, and leaving behind a sicker risk pool, and AHIP has argued since 2025 members with no claims in a given year are a normal part of any insurance pool, because a low utilizer one year often becomes a high utilizer the next. The administration reads the same pattern differently. A June report from the HHS Office of the Assistant Secretary for Planning and Evaluation (ASPE) counted a record 40 percent of enrollees in $0 premium cost-sharing reduction plans with zero claims in 2024 and described the figure as highly suggestive of improper enrollment by brokers.
Whichever reading holds in your market, the effect on your plan shows up in three places. Your 2026 risk adjustment transfer depends on the risk profile of the members who remain against everyone else who remains, your APTC revenue reflects any recoupment tied to canceled enrollments, and you filed your 2027 premiums before CMS announced any of these cancellations. Plans with a heavier concentration of broker-submitted, low-utilization enrollment will feel each of those effects more than plans whose members enrolled directly.
ACA enrollment fell about 13 percent this year for a mix of reasons, and the mix matters for your plan, because members removed for a documented cause and members who left for cost reasons carry different risk profiles and shape how much of the risk pool shift you absorb.
The broker channel heading into open enrollment
ASPE found more than 80 percent of the zero-premium plan cancellations tracked through May 2026 involved agent- or broker-assisted enrollments, which explains why CMS aimed both actions at the same channel. Existing brokers face new requirements of their own, including identity re-verification through Login.gov or ID.me, a Social Security number or immigration document number on applications for everyone other than newborns, and an electronic consumer authorization step CMS plans to put in place before open enrollment.
For carriers selling in both markets, the overlap is operational as much as regulatory. Many of the agents working your exchange book also sell your Medicare Advantage plans, and their fall calendar now carries AEP from October 15 to December 7 alongside an exchange open enrollment running from November 1 through January 15 on HealthCare.gov. The moratorium leaves Medicare Advantage broker oversight untouched, since CMS governs Medicare Advantage brokers through separate marketing and compensation rules, and the scrutiny on broker-submitted exchange applications sits beside the program integrity focus your compliance team already sees in Medicare Advantage and Medicaid, including the Medicaid fraud war room we covered in July.
The runway to January
The cancellations are already in effect, the broker pause runs through February 1, 2027, and comments on the rule close November 21. Open enrollment on HealthCare.gov opens November 1, with December 15 as the deadline for January 1 coverage and a final close on January 15, 2027. The additional verification CMS announced has no published end date, so your 2026 membership count and your 2027 starting point are both still settling. HHS typically releases its risk adjustment summary report by the end of June, which gives your risk adjustment and finance teams most of the first half of 2027 to model the removals against your EDGE server data before the benefit year 2026 transfer figures are final.
The 27th Risk Adjustment Forum brings ACA mechanics into the room with the hands-on Mastering ACA Risk Adjustment workshop, covering payment transfers, data integrity, and audit readiness, plus a session on HHS recalibration, EDGE data, and the appeals gap many ACA plans overlook. Join us October 27-29 at the Hyatt Regency Orlando.