760,000 ACA Plans Canceled: A Florida Physician Guide (2026)

On August 31, 2026, the Centers for Medicare and Medicaid Services canceled approximately 315,000 HealthCare.gov enrollments covering more than 760,000 people. The agency did not announce it until September 22. For three weeks in between, some of those patients sat in Florida exam rooms with insurance cards that no longer worked, and the practices that saw them will find out when the claims come back.

What CMS Did

The CMS fact sheet describes the canceled policies as “unauthorized enrollments,” confirmed after a joint review with the health insurance companies. The common features, according to the agency and the trade press that covered the announcement, were applications submitted with agent or broker assistance that lacked verified citizenship or immigration documentation, and members whom insurers could not reach and for whom no claims could be identified. CMS expects the cancellations to return about $2.2 billion in advance premium tax credits to the Treasury.

The same announcement covered the brokers. Since January, CMS has sent termination notices to more than 200 agents and brokers. Over the summer it issued 569 notices of intent to terminate Exchange Agreements for agents who submitted 2026 applications without Social Security numbers or immigration document numbers. On September 22, CMS published an interim final rule imposing a temporary moratorium on registering any agent or broker for 2027 who does not already hold an active 2026 agreement. Morgan Lewis, which analyzed the rule, expects the moratorium to run through February 1, 2027, which means it covers the entire open enrollment period that begins November 1. Every existing broker must also re-verify identity through Login.gov or ID.me, and starting with the 2027 plan year, a broker cannot touch a consumer’s application without the consumer’s electronic authorization.

The review is not finished. HFMA reports that CMS intends to verify eligibility for at least 419,000 additional enrollees. Morgan Lewis counts nearly 1.2 million individuals who have received verification requests with 30 days to respond. Anyone who does not respond in time can expect the same outcome as the first 760,000.

Why Florida Is the Center of This

CMS has not released a state breakdown. It does not need to for a Florida physician to understand the exposure. Florida had 4,538,772 marketplace plan selections for 2026 through HealthCare.gov as of January 15, according to the CMS open enrollment snapshot, the largest total of any state and about one in five of all marketplace plan selections in the country. The action applies only to the federally facilitated marketplaces and the state-based exchanges that use the federal platform, and Florida has never built its own exchange.

Florida is also where the broker fraud that prompted this action has been prosecuted. In January, a former vice president of the Fiorella Insurance Agency in Stuart was sentenced to 35 months in federal prison for a scheme that enrolled thousands of people, many of them homeless, in marketplace plans for which they were ineligible, paying them five or ten dollars each to sign up and collecting the commissions. The government put the loss to the program at $134 million from that one agency. CMS found that newly registered brokers were 2.8 times more likely to have unresolved income verification problems and 2.6 times more likely to have unresolved citizenship or immigration verification problems. That is the statistical shape of the same business model.

A patient enrolled by one of those brokers may not know a broker did it. The person who was reachable on the application was the broker, not the patient, which is exactly why the insurer could not establish contact. When that patient arrives for a visit, the card in the wallet looks the same as it did in July.

What Happens to the Claims

None of the government documents released so far say what happens to services rendered between August 31 and the date the patient learns of the cancellation. The CMS press release and fact sheet are silent on claims. None of the trade coverage found a reinstatement path in the announcement, and stakeholders quoted by Morgan Lewis said the cancellations appeared to fall outside the normal termination process. Cynthia Cox of KFF, quoted in the Medical Economics recap, questioned whether the removal process was appropriate and whether every canceled policy involved a fraudulent enrollment.

The practical reading is that September claims on a canceled policy will deny for no coverage, and the patient becomes a self-pay account for a visit both parties believed was insured. FindLaw’s consumer guidance, published September 24, lays out the patient’s options: a marketplace appeal within 90 days of the eligibility notice, the plan’s internal grievance process, and a request for a special enrollment period, which is not automatic when coverage is canceled for alleged fraud. A Florida physician cannot file those appeals for the patient, but the practice will be the first place many of these patients learn that there is something to appeal.

What Florida Physicians Should Do Now

1. Run a real-time eligibility check on every marketplace patient before the visit, not at check-in and not from the card. Every carrier on the Florida exchange will show a termination date in its portal if one exists. Pull a report of every marketplace patient seen since September 1 and re-verify that list this week.
2. Tell the front desk what to say. A patient whose plan was canceled is not a fraud suspect. Give staff a one-paragraph script: the government canceled a large number of marketplace policies on August 31, the patient may not have been told, here is the HealthCare.gov number, and here is how to ask for an appeal and a special enrollment period.
3. Hold, do not write off. If a September claim denies for termination, hold the balance for 90 days while the patient appeals rather than sending it to self-pay collections. A reinstated policy pays the claim; a patient who was sent to collections while appealing does not come back.
4. Check your own contact data. The enrollments CMS canceled were the ones where the insurer could not reach the member. Remind marketplace patients to update the phone number and address on their HealthCare.gov account, because the verification requests going to 1.2 million people are being sent to the address on file.
5. None of this constitutes legal advice, so if a practice manager, biller, or anyone else in your office has been enrolling patients in marketplace plans, or referring them to a broker in exchange for anything of value, have a health care attorney review the arrangement before November 1. The broker moratorium and the identity re-verification are the first steps of a broader enforcement effort, and Florida is where it has been prosecuted.

The Bigger Picture

The federal government found fraud in the marketplace, and the enforcement fell on patients and on the practices that treat them. The brokers who built the scheme were paid at enrollment and will be gone before the first denial arrives. Physicians did not design that incentive, and the profession should say so through the Florida Medical Association and the specialty societies when CMS takes comment on the interim final rule. A verification system that cancels coverage without telling the treating physician was built without asking one.

For more on patients losing coverage, see our coverage of the immigrant Medicaid cutoff in Florida, the 51 Medicare Advantage plans Florida is losing for 2027 and CMS payment suspensions and Medicaid revalidation. All of our reporting on this subject is collected in our guide to Medicare and payer changes for 2027.

Frequently Asked Questions

Why did CMS cancel 760,000 ACA marketplace enrollments in 2026?

CMS canceled approximately 315,000 enrollments covering more than 760,000 people on August 31, 2026, after a joint review with insurers identified them as unauthorized: broker-assisted applications without verified citizenship or immigration documentation, members the insurer could not contact, and policies with no identifiable claims. The agency announced the action on September 22 and expects to recover about $2.2 billion in premium tax credits.

How do Florida physicians find out if a patient’s marketplace plan was canceled?

Run an electronic eligibility check through the payer portal or clearinghouse before the visit. A canceled policy shows a termination date, and patients often have not been told. Re-verify every marketplace patient seen since September 1, 2026, because the cancellations took effect three weeks before they were announced.

Can a patient in Florida get their canceled ACA coverage back?

The patient can file a marketplace appeal within 90 days of the eligibility notice, use the health plan’s internal grievance process, and request a special enrollment period. A special enrollment period is not automatic when coverage is canceled for alleged fraud, so the patient has to ask. Open enrollment for 2027 begins November 1, 2026.

What is the CMS broker moratorium for the 2027 plan year?

An interim final rule published September 22, 2026 stops the registration of any agent or broker for 2027 who does not already hold an active 2026 Exchange Agreement, expected to last through February 1, 2027. Existing brokers must re-verify their identity through Login.gov or ID.me, and consumers must give electronic authorization before a broker can act on their application.

This article was drafted with the assistance of AI writing tools, then reviewed, edited, and approved by Dr. Sean C. Orr, M.D., who holds full editorial responsibility for its content. The header illustration was created with AI image tools.

References

1. Centers for Medicare & Medicaid Services, “CMS Cracks Down on Fraud, Waste, and Abuse in the Federal Health Insurance Marketplace” (press release, September 22, 2026). cms.gov
2. Centers for Medicare & Medicaid Services, “Federal Marketplace (FFE and SBE-FP) Anti-Fraud Actions” (fact sheet, September 2026). cms.gov
3. Fierce Healthcare, “CMS to cancel ACA coverage for 760K, crack down on brokers in latest anti-fraud push” (September 22, 2026). fiercehealthcare.com
4. Healthcare Dive, “CMS freezes new ACA broker registrations for 2027, culls ‘unauthorized’ enrollees” (September 23, 2026). healthcaredive.com
5. Morgan Lewis, “CMS Cancels Marketplace Enrollments and Imposes Moratorium on New ACA Broker Registrations” (September 2026). morganlewis.com
6. HFMA, “CMS cites ACA marketplace enrollment fraud in issuing 760,000 coverage cancellations” (September 23, 2026). hfma.org
7. FindLaw, “760,000 ACA Enrollees Were Dropped Over ‘Fraud’ Claims. Here’s What Consumers Need to Know.” (September 24, 2026). findlaw.com
8. Centers for Medicare & Medicaid Services, “Marketplace 2026 Open Enrollment Period Report: National Snapshot” (January 28, 2026). cms.gov
9. Insurance Journal, “Florida Insurance Agency VP Sentenced to 3 Years in Massive ACA Fraud Scheme” (January 8, 2026). insurancejournal.com
10. Medical Economics, “CMS cancels ACA coverage for 760,000; bill would ban corporate ownership of practices; physician pay rises” (weekly recap, September 25, 2026). medicaleconomics.com
11. Florida Hospital News and Healthcare Report, “CMS Cracks Down on Fraud, Waste, and Abuse in the Federal Health Insurance Marketplace” (September 23, 2026). southfloridahospitalnews.com