Patient Protection and Affordable Care Act; Marketplace Integrity and Affordability

Published June 25, 2025. Takes effect August 25, 2025. printed at 90 FR 27074. amending 45 CFR 147, 45 CFR 155, 45 CFR 156.

In plain English

This changes the rules for health plans sold on the marketplace. It covers who may sign up.

Read it at the Federal Register →

What the Rule Says It Does

This final rule revises standards relating to denial of coverage for failure to pay past-due premium; excludes Deferred Action for Childhood Arrivals recipients from the definition of "lawfully present;" establishes the evidentiary standard HHS uses to assess an agent's, broker's, or web-broker's potential noncompliance; revises the Exchange automatic reenrollment hierarchy; revises standards related to the annual open enrollment period and special enrollment periods; revises standards relating to failure to file and reconcile, income eligibility verifications for premium tax credits and cost-sharing reductions, annual eligibility redeterminations, de minimis thresholds for the actuarial value for plans subject to essential health benefits (EHB) requirements, and income-based cost-sharing reduction plan variations. This final rule also revises the premium adjustment percentage methodology and prohibits issuers of coverage subject to EHB requirements from providing coverage for specified sex-trait modification procedures as an EHB.

This is the rule's own summary, as the Federal Register prints it.

The Orders It Names

The rule names these orders itself. What it does about them is a reading, and none is recorded here.

How This Rule Is Quoted

Federal Register documents are United States government works and are not under copyright. The summary is quoted as printed and the rule itself is one click away, because an index is not a mirror.