ACA Enrollment Opens With New Identity Checks

Open enrollment for Affordable Care Act health insurance began on Nov. 1 in most states, introducing a series of stricter verification rules and cost changes for consumers. Idaho, Connecticut, and Massachusetts launched their periods earlier, while other states permitted preliminary rate checks. The new framework aims to reduce fraud but introduces friction for millions of shoppers.

The Centers for Medicare & Medicaid Services implemented new identity requirements for consumers using agents in the 29 states served by the federal marketplace. Users must now authorize specific agents via a one-time code sent by text, email, or phone. Individuals classified as high-risk, such as first-time applicants or those switching states, must verify their identity through third parties like Experian. Joshua Brooker, an insurance agency owner in Pennsylvania, warned that up to one in five consumers might face this extra proofing, potentially causing some to drop out entirely.

A separate rule creates a barrier for new sales agents. The agency paused registrations for brokers not listed in 2026, meaning they cannot assist with 2027 enrollments until February. Jason Fine, a Florida brokerage owner, said the move favors large call centers with permanent staff over small firms that hire seasonally. Agent groups have reacted with legal action. The National Association of Benefits and Insurance Professionals sued the administration on Oct. 15, arguing the rule unfairly targets 19,000 new agents. Health Agents for America filed a suit on Oct. 21 seeking a temporary restraining order.

Financial changes accompany the administrative shifts. Premiums are expected to rise by 15%, a lower increase than the 26% jump seen last year. Most shoppers will still receive subsidies, though the enhanced subsidies that expired at the end of 2025 are no longer available. The income cap for subsidies remains at four times the federal poverty rate, set at $63,840 for a single person and $109,280 for a family of three. The out-of-pocket maximum will increase by 13% to $12,000 for individuals and $24,000 for families.

Legislative changes also limit access for specific immigrant groups. The One Big Beautiful Bill Act removes subsidy eligibility for many lawfully present residents, including H-1B visa holders and refugees. Green-card holders and citizens of Micronesia, the Marshall Islands, or Palau retain their eligibility. Experts advise consumers to avoid automatic renewals and compare plans, noting that some insurers, including Cigna, have exited certain markets.