ACA Exchanges

CMS proposes requiring eligibility verification before consumers receive ACA Exchange premium tax credits or income-based cost-sharing reductions, beginning with 2028 health plans. The rule could shape future Exchange verification, data-matching, and document-processing requirements, but it is a proposal—not a solicitation or contract award—and comments are open for 30 days after publication.

The Centers for Medicare & Medicaid Services finalized a rule for 2027 that reduces user fees and enhances oversight of ACA Exchanges. These changes will impact budgeting and contracting strategies for state agencies and insurers starting in 2028, as states take on new cost-sharing responsibilities.