CMS plans to roll back limits on nonstandard ACA plan options
By Paige Minemyer / February 9, 2026
The Trump administration is aiming to roll back limits on the plan designs insurers can offer on the Affordable Care Act's (ACA's) exchanges.
Under the Biden administration, the Centers for Medicare & Medicaid Services (CMS) implemented regulations that limited insurers to two nonstandard plan designs per metal level on the ACA marketplaces, with the goal of simplifying the shopping experience for consumers.
In the proposed Notice of Benefit and Payment Parameters for the 2027 plan year, released Feb. 9, the CMS said it intends to discontinue those limits as well as requirements that plans offer standardized options on the exchanges. To ease potential disruption, the agency said it will allow payers to choose whether to keep the standardized plan options they currently offer, per a fact sheet.
"These proposed policies would reduce issuer and HHS burden and regulatory complexity and enhance flexibility for issuers to innovate in plan design," the CMS said in the fact sheet.
In addition, the agency is proposing to allow insurers to offer catastrophic coverage in one-year terms or in longer terms of consecutive years, up to 10. The CMS said this will allow for greater investment in the long-term care of individuals. The CMS is also seeking to rethink hardship exemptions for certain individuals over age 30, allowing more people to choose a catastrophic plan if they want to.
The proposed rule further aims to expand affordable options by allowing for plans that include lower deductibles but higher out-of-pocket maximums. The CMS said it would also allow certain innovative, non-network plans to obtain qualified health plan status if they can demonstrate a broad enough slate of provider options.
Beyond aiming to allow more options on the exchanges, the CMS said the rule would promote more modern network adequacy and provider access rules to support transparency while eliminating duplicative oversight measures.
The rule comes as legislators continue to debate what future, if any, there may be for enhanced premium tax credits for marketplace plans. The existing tax credits, which were implemented as part of the post-COVID recovery, ran out Jan. 1.
In the rule, the CMS proposes stronger eligibility and income checks alongside stronger enforcement policies to "ensure premium subsidies are reserved for eligible individuals and to better protect consumers from improper enrollments and unauthorized plan changes," according to a press release.
It would institute new legal requirements around eligibility for tax credits and other assistance for immigrants as well, the agency said.
The CMS also said it planned to roll out stronger standards for brokers and agents to deter fraud and misleading marketing.
“We are cracking down on improper and misleading practices while giving states and health plans more room to innovate and compete," CMS Administrator Mehmet Oz, M.D., said in the press release. "The goal is simple: lower costs, more choice, and Exchanges that work as intended."