Some of the more than 760,000 people who recently disenrolled from Affordable Care Act (ACA) Marketplace coverage are getting it back. KFF Health News reports that CMS is reinstating coverage for a small number of consumers whose policies shouldn’t have been canceled.
The agency isn’t disclosing how many reinstatements have occurred, or whether additional cases could emerge as consumers discover their coverage is no longer active. Here’s what agents should understand to help clients avoid unnecessary coverage disruptions.
What Happened to the 760,000 ACA Enrollees?
CMS canceled about 315,000 Marketplace policies on August 31, 2026, covering more than 760,000 people. CMS said these cancellations were unauthorized enrollments that resulted in the recovery of about $2.2 billion in advance premium tax credit payments.
CMS teamed up with health insurance companies to identify suspicious enrollments and verify whether consumers had approved their coverage. This is part of a larger federal effort to improve Marketplace oversight, stop improper subsidy payments, and prevent unauthorized enrollments.
Why Is CMS Reinstating Some Enrollees?
According to KFF Health News, the agency initially identified nearly 1.2 million enrollments with four characteristics:
- Missing Social Security numbers or immigration document numbers.
- Enrollment assistance from an insurance agent or broker.
- No monthly premium owed by the consumer.
- No recorded insurance claims or contact with the health plan.
Apparently, CMS disenrolled these 760,000 enrollees using the above criterion as justification. Now, CMS is reinstating coverage for some of these people who call the Marketplace to ask about what happened to their ACA coverage and to show that their enrollment was legitimate.
Why ACA Insurance Agents Should Take Note
It’s possible for any of your ACA clients affected by this CMS action to regain their coverage. KFF Health News reports that CMS may have an expedited review process for consumers who believe their coverage was improperly canceled.
The only certainty is that some of these consumers are seeing their ACA coverage reinstated after contacting the Marketplace and completing the process.
Another 419,000 Enrollments Are Under Review
The review isn’t finished. KFF Health News reports that another 419,000 Marketplace enrollments are being examined as part of the next phase of CMS’s anti-fraud initiative.
Insurance companies are expected to report how many affected consumers fail to respond to outreach efforts around mid-to-late November. That means additional cancellations could occur during the 2027 OEP.
This is another reason to keep client contact information up to date and to encourage consumers to respond promptly to legitimate Marketplace and insurer communications.
What ACA Agents Should Do Right Now
While CMS continues to review enrollments, here are some practical steps to help protect your clients and avoid problems.
Verify Coverage for Clients Who Report Unexpected Changes
If a client gets a cancellation notice or has a coverage problem, help them check their current enrollment status directly with the Marketplace or their insurance company.
Encourage Clients to Respond to Verification Requests
Remind clients to open mail from the Marketplace and insurers, reply to real requests, and keep their contact details updated.
Maintain Accurate Enrollment Documentation
Keep records of consumer consent, application reviews, and enrollment confirmations to make it easier to investigate any issues.
Help Clients Understand Reinstatement Options
Consumers who believe their coverage was canceled incorrectly should contact the Marketplace promptly. Agents can help them understand the process and gather relevant information.
Some consumers may have been removed incorrectly. Approach each situation individually and focus on verifying the facts.
Everyone Wants Consumer Protection, But Without Disrupting Legitimate Coverage
Everyone wants to stop unauthorized enrollments. No trusted advisor should enroll a consumer in coverage without their knowledge or permission, and federal subsidies should go only to eligible individuals.
But identifying improper enrollments also requires accuracy. The reinstatements show why careful verification and accessible correction procedures matter.
Sometimes, consumers can be affected by broader administrative reviews they don’t fully understand. As CMS continues to review Marketplace enrollments, ACA agents have an opportunity to provide clarity, help clients verify their coverage, and address issues before they result in disenrollment.
The Agility Difference
Agility’s ACA experts are here to answer any ACA agents’ questions about this and the best ways to finish your OEP preparations. You can call (866) 590-9771 or email support@enrollinsurance.com for immediate assistance from the ACA team.
If you have questions or want to talk to our Medicare, CHOICE, Group, life, or ancillary experts, reach out to our dedicated Producer Support at this same phone number or email address. We can add you to our weekly email list for tips and updates.
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