Julie Appleby | KFF Health News

Unauthorized switching of Affordable Care Act plans appears to have tapered off in recent weeks based on an almost one-third drop in casework associated with consumer complaints, say federal regulators. The Centers for Medicare & Medicaid Services, which oversees the ACA, credits steps taken to thwart enrollment and switching problems that triggered more than 274,000 complaints this year through August.

Now, the annual ACA open enrollment period that began Nov. 1 poses a real-world test: Will the changes curb fraud by rogue agents or brokerages without unduly slowing the process of enrolling or reducing the total number of sign-ups for 2025 coverage?

“They really have this tightrope to walk,” said Sabrina Corlette, co-director of the Center on Health Insurance Reforms at Georgetown University. “The more you tighten it up to prevent fraud, the more barriers there are that could inhibit enrollment among those who need the coverage.”

CMS said in July that some types of policy changes — those in which the agent is not “affiliated” with the existing plan — will face more requirements, such as a three-way call with the consumer, broker, and a healthcare.gov call center representative.

In August, the agency barred two of about a dozen private sector online-enrollment platforms from connecting with healthcare.gov over concerns related to improper switching.

And CMS has suspended 850 agents suspected of being involved in unauthorized plan-switching from accessing the ACA marketplace.

Still, the clampdown could add complexity to enrollment and slow the process. For example, a consumer might have to wait in a queue for a three-way call, or scramble to find a new agent because the one they previously worked with had been suspended.

Given that phone lines with healthcare.gov staff already get busy — especially during mid-December — agents and policy analysts advise consumers not to dally this year.

“Hit the ground running,” said Ronnell Nolan, president and CEO of Health Agents for America, a professional organization for brokers.

Meanwhile, reports are emerging that some rogue entities are already figuring out workarounds that could undermine some of the anti-fraud protections CMS put in place, Nolan said.

“Bottom line is: Fraud and abuse is still happening,” Nolan said.

Brokers assist the majority of people actively enrolling in ACA plans and are paid a monthly commission by insurers for their efforts. Consumers can compare plans or enroll themselves online through federal or state marketplace websites. They can also seek help from people called assisters or navigators — certified helpers who are not paid commissions. Under a “find local help” button on the federal and state ACA websites, consumers can search for nearby brokers or navigators.

CMS says it has “ramped up support operations” at its healthcare.gov marketplace call centers, which are open 24/7, in anticipation of increased demand for three-way calls, and it expects “minimal wait times,” said Jeff Wu, deputy director for policy of the CMS Center for Consumer Information and Insurance Oversight.

Wu said those three-way calls are necessary only when an agent or a broker not already associated with a consumer’s enrollment wants to change that consumer’s enrollment or end that consumer’s coverage. It does not apply to people seeking coverage for the first time.

Organizations paid by the government to offer navigator services have a dedicated phone line to the federal marketplace, and callers are not currently experiencing long waits, said Xonjenese Jacobs, director of Florida Covering Kids & Families, a program based at the University of South Florida that coordinates enrollment across the state through its Covering Florida navigator program.

Navigators can assist with the three-way calls if a consumer’s situation requires it.

“Because we have our quick line in, there’s no increased wait time,” Jacobs said.

The problem of unauthorized switches has been around for a while but took off during last year’s open enrollment season.

Brokers generally blamed much of the problem on the ease with which rogue agents can access ACA information in the federal marketplace, needing only a person’s name, date of birth, and state of residence. Though federal regulators have worked to tighten that access with the three-way call requirement, they stopped short of instituting what some agent groups say is needed: two-factor authentication, which could involve a code accessed by a consumer through a smartphone.

Unauthorized switches can lead to a host of problems for consumers, from higher deductibles to landing in new networks that do not include their preferred physicians or hospitals. Some people have received tax bills when unauthorized policies came with premium credits for which they did not qualify.

Unauthorized switches posed a political liability for the Biden administration, a blemish on two years of record ACA enrollment. The practice drew criticism from lawmakers on both sides of the aisle; Democrats demanded more oversight and punishment of rogue agents, while Republicans said fraud attempts were fueled by Biden administration moves that allowed for more generous premium subsidies and special enrollment periods. The fate of those enhanced subsidies, which are set to expire, will be decided by Congress next year as the Trump administration takes power. But the premiums and subsidies that come with 2025 plans that people are enrolling in now will remain in effect for the entire year.

The actions taken this year to thwart the unauthorized enrollments apply to the federal marketplace, used by 31 states. The remaining states and the District of Columbia run their own websites, with many having in place additional layers of security.

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For its part, CMS says its efforts are working, pointing to the 30% drop in complaint casework. The agency also noted a 90% drop in the number of times an agent’s name was replaced by another’s, which it says indicates that it is tougher for rival agents to steal clients to gain the monthly commissions that insurers pay.

Still, the move to suspend 850 agents has drawn pushback from agent groups that initially brought the problem to federal regulators’ attention. They say some of those accused were suspended before getting a chance to respond to the allegations.

“There will be a certain number of agents and brokers who are going to be suspended without due process,” said Nolan, with the health agents’ group. She said that it has called for increased protections against unauthorized switching and that two-factor authentication, like that used in some state marketplaces or in the financial sector, would be more effective than what’s been done.

“We now have to jump through so many hoops that I’m not sure we’re going to survive,” she said of agents in general. “They are just throwing things against the wall to see what sticks when they could just do two-factor.”

The agency did not respond to questions asking for details about how the 850 agents suspended since July were selected, the states where they were located, or how many had their suspensions reversed after supplying additional information.

NEW YORK (AP) — Thousands of Microsoft 365 customers worldwide reported having issues with services like Outlook and Teams on Monday.

In social media posts and comments on platforms like outage tracker Downdetector, some impacted said that they were having trouble seeing their emails, loading calendars or opening other Microsoft 365 applications such as Powerpoint.

Microsoft acknowledged “an issue impacting users attempting to access Exchange Online or functionality within Microsoft Teams calendar” earlier in the day. In updates posted on X, the social media platform formerly known as Twitter, the company’s status page said it identified a “recent change” that it believed to be behind the problem — and was working to revert it.

Microsoft shared that it was deploying a fix — which, as of shortly before noon E.T., it said had reached about 98% of “affected environments.”

Still, the company’s status page later added, targeted restarts were “progressing slower than anticipated for the majority of affected users.”

As of midday Monday, Downdetector showed thousands of outage reports from users of Microsoft 365, particularly Outlook.

A man who was shot and killed in a vehicle in St. Paul on Friday afternoon, as two young children were in the backseat, was identified Monday as a 26-year-old.

Andre Lorenzo Mitchell, of Minneapolis, was found with multiple gunshot injuries to his upper body in the 600 block of Aurora Avenue.

Officers responded to the Summit-University neighborhood about 1:30 p.m. Friday on multiple 911 calls reporting shots fired and that a person had apparently been shot.

Mitchell was inside a parked vehicle with another man, an infant and a toddler when a small dark vehicle, possibly a sport-utility vehicle, drove by and someone fired shots. The other three people were not injured, but investigators found the carseat that held the infant had holes from two bullets that were “extremely close to striking the child,” said Sgt. Mike Ernster, a police spokesman, on Friday.

No one has been arrested and the investigation is ongoing. Police said the incident did not appear random.

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By Kimberly Palmer, NerdWallet

Hosting the Thanksgiving meal — with its traditional turkey, multiple sides and showstopper pie — can be daunting. But with a little preparation, it can be one of the most affordable ways to feed a large group.

“In general, Thanksgiving is one of the cheapest holidays to host. The foods are so cheap — potatoes, squash, carrots, apples, turkey,” says Andrea Dekker, who publishes simple home organization and cooking tips on her eponymous website.

Indeed, the American Farm Bureau Federation, an agricultural industry group that tracks food prices, reports that in 2024, the classic Thanksgiving meal for 10 costs just over $58. That’s a decrease of 5% from last year, but 19% higher than five years ago.

In addition to selecting the right ingredients, the following strategies can also make it easier to host Thanksgiving on a budget:

1. Focus on seasonal ingredients

Try featuring root vegetables like sweet potatoes and carrots, which are in season and affordable, in your Thanksgiving meal, recommends Annie Berger, co-founder of Meal Better, a weeknight dinner planning service. She says the freshest veggies may not even need to be peeled as long as they get a good scrub.

“They’re seasonal, inexpensive and colorful,” she says.

Bari Tessler, a financial therapist in Boulder, Colorado, and author of “The Art of Money,” makes a galette from scratch for dessert, selecting the fruit ingredient based on what’s in season or on sale at the moment. That could include berries, apples, plums or cherries.

Dekker suggests leveraging ingredients you may already have tucked away at home. She pulls all of the bread ends out of her freezer, which she saves throughout the year for baked French toast and stuffing.

“Otherwise, I would throw them away, but if you add Craisins, sausage and apples, it’s almost like a free side dish,” she says.

Dekker also heads to her local orchards in western Michigan to pick up bags of blemished produce sold at a discount.

“You can turn them into apple sauce, pies or apple bread,” she says.

2. Substitute high-cost items

“Stick with recipes that don’t have a laundry list of ingredients,” says Brooke Caison, food editor at Delish, a website that features recipes, videos and food news.

If you buy an obscure spice for a specific dish, you might not use it again until next year, she adds.

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Caison also suggests making last-minute substitutions when you see what’s on sale at the grocery store.

“Maybe you’re making green bean casserole but you see Brussels sprouts on sale. Be OK with that substitution,” she says.

Casseroles that feature canned goods as their base — such as canned corn and canned pineapple — make cost-effective side dishes, she adds, noting that pineapple casserole is one of her family’s favorites.

If you want to serve greens, Caison suggests braised collard greens or bacon-fried cabbage. Those leafy vegetables tend to be lower-cost than salad mixes like arugula.

“If mustard greens are on sale, then go for that,” she says.

(Kimberly Palmer shares how she’s hosting Thanksgiving dinner for under $150.)

3. Make the meal a potluck

Inviting guests to bring their own dishes to share is an easy and fun way to host a Thanksgiving meal, says Amanda Christensen, an accredited financial counselor and extension professor at Utah State University.

“It’s a great way to include everyone in the planning as well as share the monetary burden,” she says.

4. Turn leftovers into new dishes

Dekker turns her leftover turkey into enchiladas, broth, soup, pot pie and alfredo.

“I don’t want to eat the same thing for the next four meals, so I figure out ways to mix it up so it doesn’t taste like Thanksgiving,” she says.

She adds that you can freeze almost anything to help the leftovers last for weeks or even months.

Caison recommends mashed potato pancakes and other creative ways to reuse food.

“Think about using leftovers at different times of day. Repurposed turkey can be an omelet for breakfast. Cranberry sauce can be a dessert. Let your mind play outside the space of just being dinner,” she says.

5. Rein in decor

While it can be tempting to purchase Thanksgiving-themed lights or banners, Dekker recommends using branches, dried flowers or pine cones instead. Evergreen trees, sage or rosemary can add warm scents to the room.

Berger says she creates a tablescape with seasonal items like apples, clementines and small squashes, which can later be rinsed and eaten.

Reusing, repurposing and recycling can unlock new levels of Thanksgiving creativity.

Kimberly Palmer writes for NerdWallet. Email: kpalmer@nerdwallet.com. Twitter: @kimberlypalmer.

The article 5 Budget-Friendly Thanksgiving Dinner Ideas originally appeared on NerdWallet.