Insurance Brokers and the ACA: Early Barriers and Options for Expanding Their Role

A group of professionals in a meeting

Interviews conducted with insurance brokers and other stakeholders across 21 states and D.C. provide an in-depth look at the many obstacles brokers encountered during the first year of enrolling individuals in health insurance marketplace plans, and identifies steps to leverage brokers more effectively.

The Issue

The report details the technical, financial and practical barriers that brokers had to overcome in the first open enrollment period, such as faulty marketplace websites, overburdened call centers, disincentives for directing people toward the most affordable plans, and a lack of expertise with low-income populations.

Key Findings

  • Brokers were instrumental in enrollment in select states.

  • Brokers in Kentucky assisted 44 percent of state residents who enrolled in the state’s marketplace.

  • In California, brokers were responsible for 39 percent of marketplace enrollment.


The authors identify six changes that would help brokers nationwide enroll more people going forward, including: 1) easy-to-use directories; 2) improved, hands-on broker training; 3) improved IT systems; 4) compensation for enrolling low-income individuals and families in Medicaid; 5) marketplace customer support tailored for the broker community; and 6) ongoing monitoring of broker-assisted enrollment to identify problems or barriers more quickly.

About the Grantee

The Urban Institute is a nonprofit, nonpartisan policy research and educational organization that examines the social, economic and governance problems facing the nation. For more information, visit Follow the Urban Institute on Twitter or Facebook More information specific to the Urban Institute’s Health Policy Center, its staff, and its recent research can be found at

About the Center on Health Insurance Reforms

The Center on Health Insurance Reforms at Georgetown University’s Health Policy Institute is a nonpartisan, expert team of faculty and staff dedicated to conducting research on the complex and developing relationship between state and federal oversight of health insurance markets. For more information visit