Article: CMS Pitches Shortening ACA Enrollment Period: 5 Things to Know

March 14, 2025

Article: CMS Pitches Shortening ACA Enrollment Period: 5 Things to Know

CMS is proposing a set of new regulations for ACA marketplaces, including shortening the annual enrollment window and rescinding eligibility for DACA recipients. In a March 10 news release, the agency said the changes are designed to address “the troubling amount of improper enrollments” in the marketplace. In the first quarter of 2024, CMS said it received 40,000 complaints of customers being enrolled in ACA plans, or switched into a new plan, without their knowledge.

Five things to know about the proposed rules:

  • The agency pitched shortening the annual enrollment period by one month.
    • Under the proposed rule, open enrollment would run from Nov. 1 to Dec. 15.
    • Currently, the open enrollment period begins Nov. 1 and ends Jan. 15.
    • The change would align more closely with enrollment dates for employer-sponsored coverage, and
    • “reduce the risk of adverse selection from consumers who otherwise may wait to enroll until they need healthcare services,” according to the agency.
  • The proposed rules would also eliminate a special enrollment period that allows individuals with incomes under 150% of the federal poverty limit to enroll in coverage in any month.
    • The policy “allows people to wait to enroll until they become sick,” the agency said.
  • The regulation would reverse a proposal by the Biden administration that would have allowed Deferred Action for Childhood Arrival recipients to enroll in ACA plans.
    • The DACA program allows individuals brought to the U.S. as children without legal status to remain in the country.
    • In December 2024, a federal judge blocked DACA recipients from enrolling in ACA plans.
  • Under the new regulations, consumers would be required to re-verify their eligibility for fully subsidized plans each year.
    • If enrollees do not verify their eligibility, they will pay a $5 monthly premium until they confirm or update their eligibility.
    • The change would cut back on fraud by ensuring individuals are aware of the coverage they are enrolled in, CMS said.
  • The rule would bar insurers from covering “sex trait modification services,” or gender-affirming care, as essential health benefits.
    • The proposal would not prohibit health plans from voluntarily covering these services, the agency said.

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