ACA Shoppers Face New ID Checks and Higher Costs as Enrollment Opens

Open enrollment for Affordable Care Act health insurance began November 1 in most states. Idaho, Connecticut, and Massachusetts started earlier in the month. Shoppers are already seeing higher prices and new administrative hurdles designed to cut down on fraud.

The Centers for Medicare & Medicaid Services introduced stricter identity checks for consumers using agents in the federal marketplace. This affects shoppers in 29 states that use the national platform. All consumers must now receive a one-time confirmation code via text, email, or phone call to authorize an agent to act on their behalf. People deemed high-risk must also verify their identity through a third party like Experian before an agent can enroll them.

CMS defines high-risk applicants as first-time buyers, those changing states, or those with monthly premiums of $30 or less. Joshua Brooker, an insurance agency owner in Pennsylvania, noted that the $30 threshold targets plans that are easier for bad agents to manipulate. He estimated that up to one in five consumers might face extra identity proofing, which could cause some to drop out of the process entirely.

Fewer brokers will be available to help shoppers this year. CMS issued a rule in September that pauses enrollment assistance for agents who were not registered in 2026. These new agents cannot help with 2027 enrollments until at least February. Jason Fine, a Florida broker, said the rule makes it hard for small agencies to hire staff for the peak season. He noted that larger call centers, which keep year-round staff, are positioned to benefit from the shortage.

Premiums are expected to rise by 15% for 2027, following a 26% increase last year. Louise Norris, a health policy analyst, said overall affordability will remain similar for most people because subsidies are tied to benchmark plan costs. However, households earning more than four times the federal poverty rate lose subsidies. That threshold is $63,840 for a single person and $109,280 for a family of three in this enrollment period.

The One Big Beautiful Bill Act, passed by Congress last year, removes subsidy eligibility for many lawfully present immigrants. This includes holders of H-1B visas, refugees, asylees, and those with pending green-card applications. Only green-card holders, certain Cuban and Haitian immigrants, and citizens of Micronesia, the Marshall Islands, or Palau remain eligible for financial aid.

Experts advise consumers not to let their plans auto-renew. They should compare premiums and coverage options online because costs change annually. The out-of-pocket maximum for individual plans will rise 13% to $12,000 in 2027, while family caps will reach $24,000. Stacey Pogue of Georgetown University said the new rules target fraud but may create unnecessary hurdles for legitimate shoppers.