Sponsors (6)
Introduced March 11, 2025 by Deborah K. Ross · Last progress March 11, 2025
The bill strengthens consumer protections and enrollment integrity by imposing tougher penalties and oversight on agents/brokers and improving transparency, at the cost of significantly increased legal and administrative burdens on agents and government (with risks of reduced in-person assistance and large aggregate fines).
Enrollees, uninsured individuals, and patients gain stronger consumer protection because agents and brokers face substantial civil and criminal penalties for negligent or knowingly false enrollments, deterring fraud and errors.
Individuals who enroll in coverage see reduced risk of sudden loss of care because the bill prevents disenrollment without the enrollee's consent, helping preserve continuity of coverage.
Consumers (potential and current enrollees) get clearer transparency and recourse because the bill requires improved notifications, website/hotline access to account information, and instructions to cancel unauthorized activity.
Agents and brokers face large new financial liability (per-applicant civil fines up to $10k–$50k for negligence and up to $200k for knowing fraud), which could reduce agent participation and limit in-person enrollment help for consumers.
Agents, brokers, and taxpayers risk disproportionate aggregate fines because the per-applicant penalty structure can produce very large total liabilities when many enrollees are affected, especially in systemic-error scenarios.
Frontline agents and brokers face increased criminal exposure because the bill creates criminal penalties (fines and up to 10 years imprisonment) for knowing false submissions, which could lead to aggressive enforcement and chilling effects on assisting consumers.
Based on analysis of 2 sections of legislative text.
Adds civil fines ($10k–$50k for negligence; up to $200k per person for knowing fraud) and criminal penalties (fines and up to 10 years) for agents/brokers who submit false Exchange enrollment information.
Adds new civil and criminal penalties for insurance agents and brokers who provide incorrect, false, or fraudulent information on applications for enrollment in Exchange-qualified health plans. The bill creates a negligence-based civil penalty ($10,000–$50,000 per affected individual), a knowing-fraud civil penalty (up to $200,000 per affected individual with specified procedural rules), and a criminal penalty (fines under federal law and up to 10 years imprisonment) while leaving existing sanctions intact.