Sponsors (2)
The bill strengthens enforcement to improve enrollment accuracy and deter fraud and sets a clear 2026 start date for new coverage rules, but it risks higher premiums, stricter coverage or administrative hurdles, and heavy penalties that could deter brokers and reduce in-person enrollment assistance.
People enrolling through Marketplace Exchanges are more likely to get accurate enrollments and receive the correct premium tax credits and coverage because the bill strengthens enforcement and data accuracy requirements.
Consumers who use Exchanges should face fewer fraudulent enrollments because agents and brokers who submit false information can be fined or criminally prosecuted.
A clear statutory effective date (January 1, 2026) gives insurers and small employers a defined timeframe to implement changes, improving compliance planning.
Agents and brokers face steep civil fines and possible criminal penalties (including imprisonment) for enrollment errors or misconduct, creating serious legal risk and fairness concerns for those who assist consumers.
If the new requirement imposes additional mandated benefits or coverage, premiums for individual and small-group plans could increase, raising costs for small employers and middle‑class families.
Consumers who need help enrolling—especially uninsured and low-income people—may lose access to in-person assistance if agents and brokers withdraw from the market to avoid liability, making enrollment harder.
Based on analysis of 3 sections of legislative text.
Modifies individual and small-group market statutory language effective for plan years starting Jan 1, 2026, and creates civil and criminal penalties for agents/brokers who submit false Exchange enrollment information effective for plan years starting Jan 1, 2027.
Introduced March 9, 2026 by Tom Barrett · Last progress March 9, 2026
Amends federal health insurance law to change unspecified language in a provision that will apply to individual and small-group market plan years beginning Jan 1, 2026, and creates new civil and criminal penalties for agents and brokers who submit incorrect, false, or fraudulent information on applications for Exchange-qualified health plans, with those penalties applying to applications for plan years beginning Jan 1, 2027. Penalties range from negligence-based civil fines ($10,000–$50,000 per individual) to knowing-and-willful civil penalties (up to $200,000 per individual, using accelerated procedures) and criminal penalties (fines and/or up to 10 years imprisonment).