NAIC raises concerns about ACA agent moratorium

The National Association of Insurance Commissioners is the latest organization to join in the fray over a recently enacted federal moratorium on new agents and brokers on the federally facilitated Affordable Care Act marketplace.

State insurance regulators leading the NAIC have sent a letter to the Centers for Medicare & Medicaid Services raising concerns about the moratorium on new agents and brokers and calling for an appeal process to help meet consumers’ needs.

For the 2027 plan year, the moratorium would prevent new agent and broker registrations in the federally facilitated marketplace and state-based marketplaces that use the federal platform to enroll consumers in coverage. CMS said the moratorium is part of its efforts to eliminate fraud in the ACA marketplace.

Open enrollment begins Nov. 1 for ACA coverage that takes effect in 2027.

“As your state partners in the enforcement of the ACA, and as state officials with responsibility to protect consumers and our markets, we fully support CMS’s goal of eliminating fraud,” the NAIC letter states. “We have long partnered with CMS to shut down unauthorized sales and plan switching schemes, identify the entities responsible and take appropriate administrative actions. However, we are concerned about the impact the recently announced moratorium could have on our markets.”

The NAIC specifically noted that existing insurers, as well as new insurers entering a market or expanding their service area, may lack the staff needed to help consumers if they can draw only from the pool of agents and brokers approved to sell marketplace policies in 2026. Some insurers may also be unable to backfill positions opened by retirements, departures or specialty changes.

“As potential issues become real problems,” the letter said, “state and federal agencies will need to work quickly to ensure consumers have the assistance they need to make appropriate coverage choices. We ask that CMS establish a method for state regulators, health insurance carriers, and insurance agencies and brokerages to appeal to CMS for an exception to the moratorium.”

The letter said state insurance regulators and CMS can fight fraudulent behavior while still working to ensure a smooth and successful open enrollment that connects consumers with the care they need.

Read the full letter.

Other organizations oppose the moratorium

The NAIC letter is the latest move to fight the agent moratorium.

Earlier this week, the National Association of Benefits and Insurance Professionals filed suit against CMS and the U.S. Department of Health and Human Services, challenging the moratorium.

NABIP said HHS and CMS acted without allowing the public to comment or making individualized findings of wrongdoing. The moratorium threatens the livelihoods of thousands of legitimate, licensed professionals who have not been accused of fraud and limits consumers’ access to professional assistance as they navigate open enrollment.

CMS’s analysis estimates that the moratorium will prevent nearly 19,000 agents and brokers from registering.

In September, Health Agents for America spoke out against the moratorium.

“Stopping new agents from entering the marketplace sends the wrong message to our industry,”  HAFA president and CEO Ronnell Nolan told InsuranceNewsNet. “It also has real financial consequences. Agencies across the country have already invested tremendous amounts of money recruiting, hiring, training, licensing, and preparing new agents for the 2027 enrollment season. These are legitimate businesses and legitimate agents preparing to serve consumers. They should not become collateral damage in the fight against fraud.”

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Susan Rupe is editor in chief, magazine, for InsuranceNewsNet. She formerly served as communications director for an insurance agents' association and was an award-winning newspaper reporter and editor. Contact her at susan.rupe@innfeedback.com.