Sponsor
Tom Barrett
Representative · R-MI
Representative · R-MI
The bill strengthens Exchange oversight and targets subsidies more accurately by adding SSN checks and a federal consent mechanism for agent enrollments, but those protections come with risks of enrollment delays, added administrative costs, and greater data-handling/privacy challenges.
State exchanges, HHS, and taxpayers: Standardizing HHS-operated consent processes and tightening SSN-based eligibility checks improves oversight and overall Exchange program integrity, helping detect and prevent fraud and administrative errors.
Taxpayers and eligible enrollees: Preventing duplicate enrollments that use the same SSN reduces improper/duplicate Advance Premium Tax Credit (APTC) payments and helps ensure subsidy dollars go to the correct consumers.
Individual consumers and small employers: Requiring explicit consumer (or employer) consent before an agent or broker can complete an Exchange enrollment increases consumer control, reduces unwanted enrollments, and lowers risk of agent-facilitated fraud or mistakes.
Uninsured individuals and some current enrollees: New SSN-matching checks and required consent/adjudication steps could delay eligibility determinations or enrollment completion, risking gaps in coverage or delayed access to care.
Taxpayers and state governments: Implementing SSN-matching workflows and a new federal consent mechanism will create additional implementation and ongoing administrative costs for HHS and state Exchanges.
Consumers and taxpayers: Increased SSN matching and broader data sharing across Exchanges raises the risk of data handling errors or privacy exposures if systems and processes are not properly secured.
Based on analysis of 6 sections of legislative text.
Requires HHS to add SSN-matching to prevent duplicate advance premium tax credits and requires HHS-operated consent for agent/broker-assisted Exchange enrollments (effective 2027).
Official title: To amend the Patient Protection and Affordable Care Act to address fraudulent enrollments in the Exchanges.
Introduced March 9, 2026 by Tom Barrett · Last progress March 9, 2026
Requires HHS to add automated Social Security number matching to Exchange eligibility systems within 60 days to identify and stop duplicate advance premium tax credit (APTC) payments, and bars effectuating Exchange enrollments through an agent or broker without the enrollee or employer giving consent via an HHS-operated mechanism for plan years beginning January 1, 2027. The bill creates new verification and consent procedures to reduce duplicate payments and ensure direct consumer authorization of broker- or agent-assisted enrollments.