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The bill strengthens Marketplace program integrity and consumer consent by adding SSN duplicate checks and a centralized enrollment consent mechanism, at the trade-off of greater privacy/data‑security risk, potential enrollment delays or gaps in coverage, and increased administrative costs and burdens.
Taxpayers and marketplace enrollees: reduces the risk of duplicate or improper advance premium tax credit payments by requiring Exchanges to check for identical SSNs before effectuating coverage, lowering improper subsidy outlays and consumers' later reconciliation liabilities.
Uninsured individuals and small employers: gives enrollees direct control over effectuating coverage by requiring a Secretary-operated consent mechanism (rather than agent/broker attestations), reducing the risk of unauthorized or fraudulent enrollments.
Federal and state programs: improves program integrity for the ACA Exchanges via an automated identity/duplicate-detection check and a centralized consent process, which can strengthen fraud prevention and consumer protection.
All applicants: increases privacy and data‑security risks by collecting and matching Social Security Numbers across enrollees, exposing highly sensitive personal information to potential breaches or misuse.
Dependents, families, uninsured individuals, and small employers: could cause enrollment delays, wrongful denials, or temporary gaps in coverage if SSN matching or the required federal consent mechanism creates processing bottlenecks or is difficult to access.
Taxpayers and state governments: increases administrative costs because Exchanges and HHS must build, operate, and maintain the SSN duplicate-detection system and a centralized consent mechanism.
Requires the HHS Secretary to add an Exchange program function to detect when a new applicant’s Social Security number exactly matches an existing Exchange enrollee for the same coverage period and to stop duplicate advance premium tax credit (APTC) payments when matches occur. Also requires HHS to create and run a consumer consent mechanism so enrollments made through agents or brokers in the individual and small-group markets are not finalized until the enrollee or employer gives consent through that federal mechanism; an agent/broker attestation alone cannot be used as proof of consent. The SSN-detection capability must be established within 60 days of enactment, and the consent requirement for agent/broker enrollments applies to plan years starting January 1, 2027.
Introduced March 9, 2026 by Tom Barrett · Last progress March 9, 2026