Oregon
Biden team’s tightrope: reining in rogue Obamacare agents without slowing enrollment • Oregon Capital Chronicle
President Joe Biden counts among his accomplishments the record-high number of people, more than 21 million, who enrolled in Obamacare plans this year. Behind the scenes, however, federal regulators are contending with a problem that affects people’s coverage: rogue brokers who have signed people up for Affordable Care Act plans, or switched them into new ones, without their permission.
Fighting the problem presents tension for the administration: how to thwart the bad actors without affecting ACA sign-ups.
Complaints about these unauthorized changes — which can cause affected policyholders to lose access to medical care, pay higher deductibles or even incur surprise tax bills — rose sharply in recent months, according to brokers who contacted KFF Health News and federal workers who asked not to be identified.
Ronnell Nolan, president and CEO of the trade association Health Agents for America, said her group has suggested to the Centers for Medicare & Medicaid Services that it add two-factor authentication to healthcare.gov or send text alerts to consumers if an agent tries to access their accounts. But the agency told her it doesn’t always have up-to-date contact information.
“We’ve given them a whole host of ideas,” she said. “They say, ‘Be careful what you wish for.’ But we don’t mind going an extra step if you can stop this fraud and abuse, because clients are being hurt.”
Some consumers are pursued when they respond to misleading social media marketing ads promising government subsidies, but most have no idea how they fell victim to plan-switching. Problems seem concentrated in the 32 states using the federal exchange.
Federal regulators have declined to say how many complaints about unauthorized sign-ups or plan switches they’ve received, or how many insurance agents they’ve sanctioned as a result. But the problem is big enough that CMS says it’s working on technological and regulatory solutions. Affected consumers and agents have filed a civil lawsuit in federal district court in Florida against private-sector firms allegedly involved in unauthorized switching schemes.
Biden has pushed hard to make permanent the enhanced subsidies first put in place during the covid pandemic that, along with other steps including increased federal funding for outreach, helped fuel the strong enrollment growth. Biden contrasts his support for the ACA with the stance of former President Donald Trump, who supported attempts to repeal most of the law and presided over funding cuts and declining enrollment.
Most proposed solutions to the rogue-agent problem involve making it more difficult for agents to access policyholder information or requiring wider use of identity questions tied to enrollees’ credit history. The latter could be stumbling blocks for low-income people or those with limited financial records, said Sabrina Corlette, co-director of the Center on Health Insurance Reforms at Georgetown University.
“That is the knife edge the administration has to walk,” said Corlette, “protecting consumers from fraudulent behavior while at the same time making sure there aren’t too many barriers.”
Jeff Wu, acting director of the Center for Consumer Information & Insurance Oversight, said in a statement that the agency is evaluating options on such factors as how effective they would be, their impact on consumers’ ability to enroll, and how fast they could be implemented.
The agency is also working closely, he wrote, with insurance companies, state insurance departments, and law enforcement “so that agents violating CMS rules or committing fraud face consequences.” And it is reaching out to states that run their own ACA markets for ideas.
That’s because Washington, D.C., and the 18 states that run their own ACA marketplaces have reported far fewer complaints about unauthorized enrollment and plan-switching. Most include layers of security in addition to those the federal marketplace has in place — some use two-factor authentication — before agents can access policyholder information.
California, for example, allows consumers to designate an agent and to “log in and add or remove an agent at will,” said Robert Kingston, interim director of outreach and sales for Covered California, the state’s ACA marketplace. The state can also send consumers a one-time passcode to share with an agent of their choice. Consumers in Colorado and Pennsylvania can similarly designate specific agents to access their accounts.
By contrast, agents can more easily access policyholder information when using private-sector websites that link them to the federal ACA market — all they need is a person’s name, date of birth, and state of residence — to enroll them or switch their coverage.
CMS has approved dozens of such “enhanced direct enrollment” websites run by private companies, which are designed to make it easier and faster for agents certified to offer insurance through healthcare.gov.
Rules went into effect last June requiring agents to get written or recorded consent from clients before enrolling them or changing their coverage, but brokers say they’re rarely asked to produce the documentation. If CMS makes changes to healthcare.gov — such as adding passcodes, as California has — it would need to require all alternative-enrollment partners to do the same.
The largest is San Francisco-based HealthSherpa, which assisted 52% of active enrollments nationally for this year, said CEO George Kalogeropoulos.
The company has a 10-person fraud investigation team, he said, which has seen “a significant spike in concerns about unauthorized switching.” They report problems to state insurance departments, insurance carriers, and federal regulators “and refer consumers to advocates on our team to make sure their plans are corrected.”
Solutions must be “targeted,” he said. “The issue with some of the solutions proposed is it negatively impacts the ability of all consumers to get enrolled.”
Most people who sign up for ACA plans are aided by agents or platforms like HealthSherpa, rather than doing it themselves or seeking help from nonprofit organizations. Brokers don’t charge consumers; instead, they receive commissions from insurers participating in state and federal marketplaces for each person they enroll in a plan.
While California officials say their additional layers of authentication have not noticeably affected enrollment numbers, the state’s recent enrollment growth has been slower than in states served by healthcare.gov.
Still, Covered California’s Kingston pointed to a decreased number of uninsured people in the state. In 2014, when much of the ACA was implemented, 12.5% of Californians were uninsured, falling to 6.5% in 2022, according to data compiled by KFF. That year, the share of people uninsured nationwide was 8%.
Corlette said insurers have a role to play, as do states and CMS.
“Are there algorithms that can say, ‘This is a broker with outlier behavior’?” Insurance companies could then withhold commissions “until they can figure it out,” she said.
Kelley Schultz, vice president of commercial policy at AHIP, the trade association for large insurance companies, said sharing more information from the government marketplace about which policies are being switched could help insurers spot patterns.
CMS could also set limits on plan switches, as there is generally no legitimate need for multiple changes in a given month, Schultz said.
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
The man wanted in connection with two Pierce County homicides was shot and killed by police in Seaside, Oregon, Pierce County Sheriff Keith Swank announced on X Wednesday night.
Hayes McCloud, 24, was identified earlier in the day by the Pierce County Sheriff’s Office (PCSO) as a person of interest in two killings — the first in Puyallup around 2:40 a.m. and the second in Tacoma shortly after 3 a.m.
On Wednesday night, authorities referred to him as a suspect.
“The suspect has been contacted by police in Seaside, Oregon,” PCSO said in a Facebook post. “We are no longer looking for the suspect and details of the contact and major incident that transpired in Oregon will be available once the investigation is concluded.”
After that announcement, Swank posted an update on X.
“After he killed the person in Tacoma, he drove away. We didn’t know where he went, but he was picked up by a Flock camera in Lewis County around 4 a.m. So we knew he was headed southbound at that point,” Swank’s post said. “The suspect was shot and killed by police in Seaside, Oregon. No cops were hurt. I’m glad he was stopped before he killed anyone else. Great police work!”
The murder suspect from the homicide on Woodland Avenue also shot and killed a person in Tacoma.
After he killed the person in Tacoma, he drove away. We didn’t know where he went, but he was picked up by a flock camera in Lewis County around 4:00 AM. So we knew he was headed…
— Sheriff Keith Swank (@SaveOurSheriff) July 9, 2026
35-year-old killed in Puyallup home early Wednesday
At 2:40 a.m. Wednesday, deputies responded to the 12500 block of Woodland Avenue E. in Puyallup after receiving reports that a man was found dead in a home. Two homeowners were at the scene when deputies arrived.
“The preliminary investigation indicates there was homicidal violence in a bedroom that eventually led outside the home,” the Pierce County Sheriff’s Office reported. “The 35-year-old male was located inside the home with multiple deadly injuries. We have no suspect in custody at this time.”
Second homicide in Tacoma less than 30 minutes later
Just after 3 a.m., police responded to the 6900 block of E. D Street in Tacoma’s Hillsdale neighborhood after multiple people reported hearing gunfire. When officers arrived, they found a man suffering from apparent gunshot wounds.
Officers began lifesaving measures, but the victim was pronounced dead at the scene.
Contributing: Frank Sumrall, MyNorthwest
Frank Lenzi is the News Director for KIRO Newsradio. Read more of his stories here.
The Oregon Country Fair is right around the corner and got an up-close preview of the annual event with generations of revelers expected to return yet again.
Vendors and construction teams were busy setting the venue up on Wednesday. It opens to the public on Friday, and organizers are expecting a big turnout.
For over fifty years, people have come together to enjoy live music, art, food and community at the event in Veneta.
“It has definitely changed and evolved and it’s definitely still holding true to the magic that has started the fair,” said fair attendee Jill Carter.
Carter has been going to the fair for about forty years, but throughout her time there, there’s always one thing on her mind.
“I’ve had a lifelong dream to do the poster, and I’ve been working on applying for a long time, and I got to do it and I’m so excited!”
Carter says over the years, she’s fine-tuned her design proposal to accurately capture the whimsey of the fair.
“In our day-to-day world, we really don’t get to connect on this kind of level of art and whimsey.”
This curated space of art and whimsey is what keeps generations returning to the fair.
“I was at a meeting the other day and somebody was a third generation Oregon Country fairgoer. Their parents were babies here. They were babies here. Now, they’re on crews that help manage the safety of this community,” says Kate Gillespie, the White Bird Rock Medicine crew coordinator.
Gillespie has been working within medical response at the fair for sixteen years.
Before fair goers even arrive, White Bird Rock Medicine works on setting up for the two hospitals provided on site as well as staffing medical crew – which consists of almost 300 medical professionals and mental health crisis workers.
“We are prepared to deal with first aid things like scrapes, bumps, bruises; injured feet are a big thing that we see – all the way up to things like cardiac events and strokes,” Gillespie explains.
And for the attendees they serve, the event is a yearly tradition that is more than just a fair – it’s a chance to catch up with old friends and make new memories.
“I think it’s really like a reunion for a lot of the people that are out here on this property,” says Gillespie.
The Oregon Country Fair runs Friday through Sunday from 11 a.m. to 7 p.m. at the intersection of Suttle Road and Bus Road in Veneta.
For more information, visit the fair website.
The Oregon attorney general will ask a court to pause Paramount’s PSKY.O $110 billion bid to acquire Warner Bros. WBD.O for 60 days, saying on Tuesday that the company withheld records of its lobbying efforts.
While Paramount has told the state it will not close the deal before July 16, Attorney General Dan Rayfield said he will ask a Multnomah County court to order the company to hand over records and to delay the deal so the state can review them.
“We’re not going to let Paramount Skydance play hide the ball so they can rush through their massive merger,” Rayfield said in a statement. “Oregonians have a real stake in this deal – in our film industry, in our economy, in the choices they’ll have as consumers.”
A Paramount spokesperson said the information Oregon seeks “has nothing to do with whether this transaction complies with Oregon’s antitrust laws and is not a legitimate basis to delay a plainly lawful, pro-competitive transaction.”
The company has provided the state with documents relevant to the merger, the spokesperson added.
Oregon is seeking documents regarding “Project Warrior,” which was Paramount’s internal code name for efforts to obtain regulatory clearance. The state is also asking for records related to the company’s efforts to lobby the Trump administration for support of the merger.
Paramount CEO David Ellison’s father, billionaire Oracle co-founder Larry Ellison, has cultivated ties with President Donald Trump, and the company has hired former Trump officials.
Oregon is also seeking information on whether Paramount had any role in the U.S. Department of Justice’s statement announcing it had cleared the deal.
While Oregon ordinarily “would afford significant weight” to the DOJ’s determination, the state plans to cite a Wall Street Journal report that officials overrode career staff attorneys at the DOJ who were leaning toward a recommendation to challenge the deal, according to documents to be filed in court that Reuters reviewed.
The DOJ issued a lengthy statement last month saying it believed the deal would “increase competition across the media and entertainment ecosystem, with benefits for American consumers and workers.”
The company has said the deal would create a stronger streaming competitor to Netflix NFLX.O and Disney DIS.N, and benefit creatives and consumers.
California, New York and other U.S. states are preparing to sue to block the deal, sources familiar with the matter told Reuters last month. The states have authority to enforce laws against mergers that they believe would unlawfully decrease competition.
Opponents of the deal, including some actors, writers and media workers, have worried that it would hurt jobs.
-
Technology2 minutes agoMedical identity theft follows you into the doctor’s office
-
Business9 minutes agoCalifornia soccer fans sue StubHub after it fails to deliver expensive World Cup tickets
-
Entertainment12 minutes agoLucas Museum to give free annual passes to South L.A. neighbors, host community preview day
-
Lifestyle17 minutes agoMeow Wolf taps famed L.A. animation house for its new Los Angeles venue
-
Politics24 minutes ago
Column: Trump decries ‘communism’ while his government takes ownership of companies
-
Science27 minutes ago‘I’d rather my house burn down than get cancer’: Herbicide use upends California’s fight to save forests
-
Sports32 minutes agoDodgers scheduled to visit White House in late July to celebrate 2025 World Series win
-
World42 minutes agoFormer US Olympian pleads not guilty in DC reflecting pool vandalism case
