Insurance Fraud Accountability Act

S. 976 would amend the Affordable Care Act to crack down on fraudulent practices by health insurance brokers and agents. The bill would address a documented problem where rogue brokers enroll individuals in ACA marketplace plans or change their coverage without consent to collect commissions, often targeting low-income consumers with misleading advertisements about free government subsidies. These fraudulent enrollments leave consumers with uncovered medical expenses, disrupted care, and unexpected tax liabilities.

If enacted, the bill would impose civil penalties on agents and brokers who submit fraudulent enrollment information, with fines ranging from $10,000 to $50,000 for negligent submissions and up to $200,000 per individual for knowingly providing false information. It would also establish criminal penalties including fines and imprisonment for up to 10 years for those who knowingly and willfully provide fraudulent information. The legislation would require brokers to act in the best interest of consumers and establish a consent verification process to notify individuals of any changes to their enrollment, agent of record, or tax subsidies. Additionally, it would require the Secretary of Health and Human Services to implement oversight and enforcement processes for broker compliance and share audit results with state insurance departments.