CMS officials also called for requiring applicants to pay any premiums they owe for old exchange plan coverage before the applicants can get new coverage; requiring exchange programs to verify that 75% of the people applying for coverage outside of the open enrollment period are really eligible to do that; and making it easier to ban agents and brokers who appear to be guilty of wrongdoing.

Related: ACA changes could impact employer plans, ICHRAs

This year, about 26 million people have signed up for private exchange plans and related forms of coverage through Healthare.gov and the state-based exchanges, according to ACASignups.net, an ACA program tracking blog.

Keeping a health insurance market stable is a complicated task. Insurers fear that seemingly small changes in enrollment and eligibility rules could change the flow of sick, high-cost enrollees in predictions that are hard to predict. If too many applicants evade the enrollment rules, and those applicants end up having high claim costs, the insurers that attract the high-cost enrollees may flee from the market.

Health insurance company executives have often talked during quarterly conference calls with securities analysts about the high cost of insuring consumers who sign up for coverage outside of the regular annual enrollment periods. Regulators and ACA exchange managers created the SEP rules to keep people from waiting until they think they're sick to pay for coverage. High claim costs for SEP applicants may be a sign that some consumers really are taking advantage of weak SEP verification rules and signing up for coverage only when they expect to have big medical bills.

CMS has also received thousands of complaints from consumers who say they were switched into new plans without their consent or signed up for exchange plan coverage by dishonest brokers without knowing it.

Many ACA exchange watchers say the new draft regulations are part of a Trump administration effort to use tougher exchange plan eligibility rules to suffocate the ACA exchange system. Most of those ACA exchange watchers are also expecting to see the Trump administration further depress ACA exchange use by ensuring that the extra ACA premium tax credit subsidies provided in response to the COVID-19 pandemic expire.

But the ACA exchange system ended up surviving Trump's first term in office, in spite of Trump administration efforts to overturn the ACA. Melamed suggests that there's reason for optimism about the new draft regulations.

"Although many of the new regulations will, in fact, shrink the enrollment in ACA, some of them will clearly also reduce the ability for people to game the system and make it harder for shady brokers to enroll people without their consent," Melamed wrote in a recent commentary.

The draft regulations are also written in such a way that they leave open the possibility that the Trump administration thinks the current level of ACA premium tax credit subsidies may be extended, Melamed says.

PNR, the FMO, says it thinks the new draft regulations are clearly aimed at rooting out bad actors who need rooting out.

"Tighter verification and compliance rules likely mean more work for each client," PNR is telling agents. "Administrative overhead will rise, which can eat into productivity if not managed efficiently."

But "the clients you do enroll are likely to be more engaged and accountable," PNR says. "This could translate to better retention and a more stable renewal base over time, as the Marketplace cleans up enrollment issues. A more stable risk pool could also mean carriers stay committed and keep offering plans in your market, which is good for business continuity."