Newsletter

COURT KEEPS ACA ENROLLMENT WINDOW OPEN FOR 2027 PLANS

A federal court has blocked Medicare (CMS) implementing certain provisions of the 2025 Marketing Integrity and Affordability Rule while litigation in the 2025 City of Columbus v. Kennedy court case continues.

CMS must keep the longer November 1 – January 15 window for 2027 ACA Open Enrollment in place. The ruling also pauses several related CMS rules that were scheduled to tighten enrollment operations for 2027, but does not block the entire 2025 Marketplace Affordability and Integrity Rule.

Open Enrollment Period: No Change for 2027

The court ruling stops CMS from reducing the 2027 Open Enrollment Period to six weeks (November 1–December 15). But it’s important to understand how this applies differently to HealthCare.gov and state‑based exchanges.

For the majority of states (including Florida) that use HealthCare.gov, the 2027 enrollment window remains November 1 through January 15. This is the same 10‑week window that has existed since 2022. The injunction ruling prevents the federal government from shortening it until or unless the injunction is overturned by an appeals court.

States that operate their own ACA platforms (e.g., CA, NY, CO, MN, etc.) also keep their existing enrollment windows. Because of the court decision:

• States do not have to shorten their enrollment periods
• States may continue using their current timelines, which are often the same or longer than HealthCare.gov
• No state is required to adopt the shorter 6‑week window that CMS attempted to impose

Bottom line: Whether a state uses HealthCare.gov or its own exchange, the longer enrollment window stays in place for 2027.

Past‑Due Premium Rule: Paused

CMS had planned to reinstate a stricter rule for 2027 requiring consumers to pay all past‑due premiums before enrolling in a new plan with the same insurer.

The injunction blocks that rule.

What this means:

• The stricter past‑due premium rule is on hold
• Consumers cannot be denied enrollment during OEP solely because they owe back premiums to the same carrier
• Carriers must continue following the more flexible standard currently in place

This prevents unpaid balances from becoming a barrier to coverage during Open Enrollment.

Income Verification Changes: Also Blocked

CMS also attempted to tighten income‑verification procedures for 2027, including:

• More aggressive documentation requirements
• Shorter deadlines to resolve income inconsistencies
• Expanded authority for exchanges to adjust APTC (advance premium tax credits, AKA subsidies) when documentation was missing

The court’s injunction freezes these changes [note: any of these rules that are deemed to be included in the 2027 Final Rule (see second article) will not be permitted to be implemented)

For 2027:

• The stricter income‑verification processes, documentation requirements and deadlines contained in the 2025 Marketing Integrity and Affordability Rule cannot be implemented

This avoids sudden administrative burdens that could have delayed or disrupted enrollments.

Bottom Line For 2027

Because of the court ruling:



• Open Enrollment stays November 1–January  15

• Past‑due premium restrictions remain paused

• Stricter proposed income‑verification rules contained in the 2025 Marketing Integrity and Affordability Rule cannot be implemented

• Both HealthCare.gov and state‑based exchanges keep their existing enrollment timelines



• The appeals process through the Federal courts must be exhausted before CMS can make any changes in these areas 

CMS ISSUES MAJOR 2027 FINAL RULE THAT RESHAPES THE ACA MARKETPLACE

In May 2026, CMS released a sweeping set of rules that will directly influence how ACA plans look and operate in 2027. These changes affect everything from premiums to plan design to how states regulate their own exchanges.

Key Parts Of The CMS 2027 Final Rule:

• Lower Exchange User Fees (intended to reduce premiums)

CMS is reducing the fees insurers pay to participate in HealthCare.gov. Lower fees → lower insurer costs → potential downward pressure on premiums.

• Stricter Eligibility and SEP Verification

CMS is tightening verification for Special Enrollment Periods and income eligibility. This includes:

• More documentation requirements

• Reinstated pre‑enrollment SEP verification

• Stronger checks to prevent improper enrollments

This is meant to reduce fraud and stabilize premiums.

Note: we expect a challenge to at least some of these provisions, alleging they are attempting to implement provisions enjoined by the injunction issued in the City of Columbus v. Kennedy case (see the first article, above)

• More Flexibility for States

States running their own exchanges get more authority over:

• Plan certification

• Network adequacy rules

• Standardized plan requirements

This means state‑based marketplaces may diverge more from HealthCare.gov.

• Changes to Standardized Plans

• CMS is removing some standardized plan requirements and allowing more non‑standardized plan options.
• This gives insurers more room to design plans — but may also make comparisons harder for consumers.

• New Flexibility for Catastrophic and Bronze Plans

CMS is allowing:

• Maximum contract terms of up to ten years for catastrophic plans. These are still annual plans, but can be renewed without redesign for up to ten years
• More variation in Bronze plan cost‑sharing

This could expand lower‑premium options for younger and healthier consumers.

Why This Matters

The 2027 Final Rule reshapes the marketplace by:

• Tightening integrity rules (excluding verification procedures put on hold by the injunction mentioned in the first article)
• Giving states more control
• Allowing more plan design flexibility
• Potentially lowering premiums
• Changing how consumers compare plans

These changes will influence plan availability, pricing, and consumer experience in 2027.

WHAT HAS HAPPENED TO 2027 ACA ENROLLMENT SINCE THE AMERICAN RESCUE PLAN ACT (ARPA) EXTENSION EXPIRED ON DECEMBER 31, 2025

The Affordable Care Act (ACA) saw record enrollment in 2022–2025 because the American Rescue Plan Act (ARPA) temporarily made Marketplace coverage much more affordable. ARPA lowered premiums for nearly everyone and eliminated the old “subsidy cliff,” allowing higher‑income households to qualify for help.

But ARPA was always temporary — and because Congress did not extend it, the enhanced subsidies expired on January 1, 2026. Now we’re seeing the full impact on 2027 enrollment.

Here’s what’s happening.

 1. Premiums Increased for Millions of Households

When ARPA expired, the old subsidy formula snapped back into place. That means:

• People with middle and higher incomes lost part or all their premium tax credits.
• Some households saw premiums rise by $100–$300 per month (or considerably more).
• Older adults (50–64) were hit hardest because their unsubsidized premiums are the highest.

Result: Many consumers who stayed enrolled in 2026 are now shopping harder, downgrading plans, or dropping coverage entirely for 2027. Others have left the marketplace and enrolled in lower-cost alternatives like short-term health insurance or ERISA-covered plans like group plans built on an individual chassis.

2. The “Subsidy Cliff” Returned

Under ARPA, no one paid more than 8.5% of household income for the benchmark plan.

Now that ARPA is gone:

• Households above 400% of the Federal Poverty Level have lost subsidies completely.
• A 60‑year‑old couple making $80,000 can now face $1,500–$2,000 monthly premiums or more with no help.

Result: Enrollment among higher‑income older adults is declining sharply for 2027. As mentioned above, others have left the marketplace and enrolled in lower-cost alternatives like short-term health insurance or ERISA-covered plans like group plans built on an individual chassis.

3. More People Are Switching to Lower‑Cost Plans

Consumers who remain in the Marketplace are shifting to:

• Bronze plans
• High‑deductible plans
• Plans with narrower networks
• Catastrophic‑style options

Result: Enrollment numbers may stay high, but plan quality and coverage levels are dropping.

4. Low‑Income Enrollment Is Holding Steady

This group still receives very strong subsidies, even without ARPA.

Result: Enrollment among low‑income individuals remains stable — the biggest declines are in the middle‑income and older‑adult segments.

5. Overall Impact on 2027 Enrollment

Here’s the big picture:

Enrollment is becoming more polarized.

• Low‑income enrollment: steady
• Middle‑income enrollment: declining
• Older adults without subsidies: sharply declining
• Plan switching: increasing
• Average premiums paid by consumers: rising

Why?

Because ARPA’s enhanced subsidies were the single biggest driver of ACA affordability — and without them, many households simply can’t absorb the higher costs.

Bottom Line

The expiration of ARPA’s enhanced subsidies has reshaped the ACA landscape for 2027:

• Premiums are higher
• Subsidies are smaller
• The subsidy cliff is back
• More people are downgrading plans or switching to non-ACA-qualified plans
• Enrollment is shifting toward lower‑income groups
• Middle‑income and older adults are feeling the squeeze

This means more people need help navigating higher costs.

About Paul Cholak

Paul has over forty years of benefits experience and has been Director of Employee Benefits for large companies, as well as a benefits consultant with major consulting firms. He understands the health and life insurance needs of individuals and families of all ages. He also has considerable experience in selling health and life insurance to employer groups.

He guides you through the steps of getting health and/or life insurance and is available to help you both BEFORE and AFTER you've made your purchase decision.