Overview
- Starting with plan year 2027, federal exchanges will limit open enrollment to Nov. 1 through Dec. 31 and allow states to set their own nine-week windows within that period.
- The rule rescinds coverage for immigrants who entered illegally as children by overturning a Biden-era policy that was blocked in 19 states.
- Temporary provisions for plan year 2026 include stricter income verifications and a new $5 monthly premium for consumers automatically reenrolled in subsidized plans.
- The final rule bans coverage of sex-trait modification as an essential health benefit beginning in 2026 across federal and affected state marketplaces.
- CMS projects the changes will save $12 billion in 2026 and lower average marketplace premiums by about 5 percent.