Action: On June 20, the Centers for Medicare and Medicaid Services (CMS) released a final rule that reforms the eligibility and the enrollment process for the Affordable Care Act (ACA) marketplace. The reforms target what CMS considers improper enrollments to deliver “improved health care coverage” and estimates it will lower cost for premiums under the ACA by 5%. The rule will come into effect on August 25, leaving businesses relatively little time to prepare before the 2026 open enrollment period begins this November. CMS estimates the rule will reduce ACA enrollment by between 750,000 and 1,800,000 people after a record enrollment year in 2025 and will likely impact the exchange markets. CMS also released a factsheet on the changes.Trusted Insights for What’s Ahead®
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