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Andrew Harnik / AP

Two new federal policies will tinker with Affordable Care Act enrollment and make online insurance brokers a lot happier. During the next open-enrollment period, individual ACA shoppers and those who work in small businesses will be able to sign up for health coverage directly from web brokers like eHealth instead of getting redirected to HealthCare.gov.

Why it matters: The changes make it clear that if the Trump administration has to carry out the law, it will put more control into the hands of the private sector. More people could ultimately sign up for ACA plans if they don't have to bounce around different websites, but there are concerns that web brokers might direct people toward health plans that aren't the best fit.

How online health brokers work: eHealth, HealthSherpa, GetInsured, Stride Health and numerous other companies show people what health plans are available. Brokers are paid commissions from the health insurance companies for every person they get to enroll.

Once the ACA went into effect, their business changed. Many people in the individual market signed up directly using HealthCare.gov or their state-based website instead of web brokers. And because ACA members had higher costs, insurers began to cut or eliminate commissions for ACA plans.

It's possible giving brokers more control could help ACA enrollment: John Desser, a top lobbyist at eHealth, told the federal government this past March that the current process is "jarring and injects a level of consumer confusion." A simpler online process could attract more young adults and make it easier for employers to enroll their part-time or seasonal employees, HealthSherpa has argued.

But there also are potential issues:

  • Brokers are not incentivized to show people the "best deals," whereas HealthCare.gov and state-based exchanges are neutral intermediaries.
  • Concerns over fraud if brokers handle sensitive tax information for people who are eligible for subsidies.
  • Less marketing to people who could get coverage outside of open enrollment. Brokers usually are not paid any commission, or receive only a severely reduced commission, for "special" enrollment options.

Worth noting: eHealth's stock is up 22% this month.

Go deeper

Updated 1 hour ago - Health

NYC firefighters union urges members to defy mayor's vaccine mandate

New York City Mayor Bill de Blasio. Photo: Michael M. Santiago/Getty Images

The president of New York City's firefighters union told reporters Wednesday that he's advised unvaccinated members to ignore Mayor Bill de Blasio's COVID-19 vaccine mandate for city workers, per Reuters.

Why it matters: Under de Blasio's order that's due to take effect Friday, unvaccinated city employees would be placed on unpaid leave. But Uniformed Firefighters Association head Andrew Ansbro said he told members that "if they choose to remain unvaccinated, they must still report for duty," according to Reuters.

3 hours ago - Health

Study: Common antidepressant guards against COVID hospitalization

A COVID-19 intensive Care Unit in Rio De Janeiro, Brazil on May 27, 2021. Photo: Fabio Teixeira/Anadolu Agency via Getty Images

The readily available antidepressant fluvoxamine significantly reduced COVID-related hospitalizations, according to a large study published Wednesday.

Why it matters: The clinical trial suggests that a cheap, readily available drug could dramatically reduce serious illness and death when prescribed early.

By the numbers: Catholics, Biden and abortion

Expand chart
Reproduced from Pew Research Center; Chart: Axios Visuals

President Biden — the second Catholic U.S. president — will meet with Pope Francis at the Vatican on Friday, as some church leaders debate whether to deny Holy Communion to politicians who support abortion rights.

By the numbers: Overall, two in three U.S. Catholics believe Biden should be allowed to take Communion despite his stance on abortion, according to polling by Pew Research Center.