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Final Rule

Patient Protection and Affordable Care Act; Marketplace Integrity and Affordability

Final rule.

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Summary:

This final rule revises standards relating to denial of coverage for failure to pay past-due premium; excludes Deferred Action for Childhood Arrivals recipients from the definition of "lawfully present;" establishes the evidentiary standard HHS uses to assess an agent's, broker's, or web-broker's potential noncompliance; revises the Exchange automatic reenrollment hierarchy; revises standards related to the annual open enrollment period and special enrollment periods; revises standards relating to failure to file and reconcile, income eligibility verifications for premium tax credits and cost-sharing reductions, annual eligibility redeterminations, de minimis thresholds for the actuarial value for plans subject to essential health benefits (EHB) requirements, and income-based cost-sharing reduction plan variations. This final rule also revises the premium adjustment percentage methodology and prohibits issuers of coverage subject to EHB requirements from providing coverage for specified sex-trait modification procedures as an EHB.

Key Dates
Citation: 90 FR 27074
Effective Date: These regulations are effective on August 25, 2025.
Public Participation
Topics:
Administrative practice and procedure Advertising Advisory committees Aged Brokers Citizenship and naturalization Civil rights Conflict of interests Consumer protection Grant programs-health Grants administration Health care Health insurance Health maintenance organizations (HMO) Health maintenance organizations (HMO) Health records Hospitals Indians Individuals with disabilities Intergovernmental relations Loan programs-health Medicaid Organization and functions (Government agencies) Public assistance programs Reporting and recordkeeping requirements Reporting and recordkeeping requirements Reporting and recordkeeping requirements Sex discrimination State and local governments Sunshine Act Taxes Technical assistance Women Youth

Document Details

Document Number2025-11606
FR Citation90 FR 27074
TypeFinal Rule
PublishedJun 25, 2025
Effective DateAug 25, 2025
RIN0938-AV61
Docket IDCMS-9884-F
Pages27074–27224 (151 pages)
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Related Documents (by RIN/Docket)

Doc #TypeTitlePublished
2025-04083 Proposed Rule Patient Protection and Affordable Care A... Mar 19, 2025

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