Earlier this week, I traveled to Washington, D.C. to attend the 2025 CMS Agent and Broker Marketplace Meetup. This wasn’t just another event, it was a chance to hear directly from the federal agency that runs the Marketplace Exchanges and to get ahead of the changes coming to the plans many Virginians rely on for health insurance.
I attended in person because staying informed is part of how I serve. My goal is to make sure that when a client works with me they are working with someone who shows up, pays attention, and brings clarity to a complex system.
Why I Went
This event was hosted by the Centers for Medicare & Medicaid Services (CMS), and I was one of about 300 agents who attended in person. Thousands more joined virtually, but I wanted to be in the room. I wanted to see and hear everything directly from the source.
Dr. Mehmet Oz, the current CMS Administrator, opened the day. Yes, that Dr. Oz. He came across as energized, funny, and sincere. His message to agents was clear: we matter. According to him, 70 percent of Marketplace enrollments come through agents, and CMS wants to strengthen our role, not weaken it.
Key Changes Virginians Should Know About
A new federal rule has been finalized, called the 2025 Marketplace Integrity and Affordability Rule. It is focused on making sure subsidies and coverage go to the right people and that the Marketplace remains stable.
Here’s What You Need To Know:
Subsidies May Change in 2026
The extra financial help many people have received since the pandemic may expire at the end of this year. If Congress does not act to extend it, premiums could increase for many enrollees in 2026. I will be monitoring this and preparing for every scenario to make sure my clients are not caught off guard.
New $5 Rule for $0 Plans
If you qualify for full financial help and do not update your application during renewal, you could be automatically charged a small $5 premium each month. This policy is designed to reduce ghost enrollments and will be effective for 2026 plan year auto-enrollments. I will be ensuring my clients are aware of this and that we need to update their 2026 applications.
Less Time to Clear Up Income Verification Issues
CMS is shortening the time people have to fix data matching problems. If your income cannot be verified or you did not file taxes correctly, your premium assistance could stop more quickly than in past years. This is a big change and highlights the importance of keeping information on Marketplace applications accurate and up to date.
Year-Round Enrollment for Low-Income Individuals Will End
Currently, people with income under 150 percent of the federal poverty level can enroll in and change coverage outside of the open enrollment period. That special rule will expire so going forward and in 2026.
My Experience at the Meetup
I listened to CMS leaders, policy experts, and fellow agents. There were sessions on compliance, outreach, and employer reimbursement programs like ICHRAs. Some of the presentations were helpful, others were more polished than practical, but overall I walked away with valuable insights and clear confirmation that things are changing.
Dr. Oz and others spoke about reducing fraud, improving systems, and making coverage more responsive to real people. They also made it clear that agents are being counted on to help communicate with and guide consumers through these changes.
My Perspective on the Future
As someone who studies trends and looks ahead, I see the Marketplace evolving into something much bigger than it is today. I believe we are moving toward a system where the Marketplace becomes the central hub for all health coverage enrollments. This includes:
- Workers receiving employer dollars through ICHRA accounts and shopping for plans themselves on the Marketplace
- Medicare and Medicaid eligibility being routed through the Marketplace Applications
- Individuals, families, and the self-employed all using the same system to choose their coverage
In my view, this is where the future is heading. And I plan to stay right at the center of it.
Why This Matters for You
Whether you are already one of my clients or just exploring your options, know this: I take your coverage seriously. I travel to events like this to stay current, to listen, and to learn. I follow the rules, explain them in plain English, and make sure you are prepared for what’s next.
If you need help with your plan, have questions about these changes, or just want a steady hand to guide you through enrollment, ITK Insurance is here.
Let’s make sure your coverage is not only active but working for you.
Maria Williams
Licensed Health Insurance Agent & Educator
Owner, ITK Insurance