Overview

• The 2025 law and the new CMS rule have imposed stricter income verification, ended automatic reenrollment, shortened open enrollment and introduced new payment and repayment requirements for Marketplace coverage.
• The Centers for Medicare and Medicaid Services estimates up to 1.8 million people could lose ACA coverage next year, with losses concentrated in GOP-led states such as Florida, Georgia, South Carolina and Texas.
• The Congressional Budget Office forecasts the rollbacks will lead to 2.1 million additional uninsured Americans by 2034 unless enhanced premium subsidies are extended.
• Insurers have filed requests for a median 18% premium increase for 2026 and Aetna has announced it will withdraw from the Obamacare exchanges.
• Democratic-led states and municipal groups have filed lawsuits challenging the rule’s implementation as Congress faces a September deadline on enhanced premium subsidies.