CMS Proposes Regulations to Lower Health Care Costs, Expand Consumer Choice, and Protect Taxpayers

Administration Marketplace Payment Rules Share CMS Proposes Regulations to Lower Health Care Costs, Expand Consumer Choice, and Protect Taxpayers Today, the Centers for Medicare & Medicaid Services (CMS) proposed regulations to lower health care costs, promote competition, and strengthen program integrity in the Federal and State-Based Health Insurance (Exchanges). The proposed Notice of Benefit and Payment Parameters for 2027 would crack down on fraud and misleading practices by agents and brokers, restore accountability for taxpayer-funded subsidies, and remove federal barriers that have limited plan innovation and driven up premiums—helping ensure coverage is more affordable and works better for consumers, taxpayers, and states. “At President Trump’s direction, HHS is driving down costs and rooting out fraud across our health insurance programs,” said Health and Human Services Secretary Robert F. Kennedy, Jr. “This proposed rule lowers premiums, expands consumer choice, cracks down on fraud, and promotes innovative coverage that prioritizes prevention and long-term health.” “This proposal puts patients, taxpayers, and states first by lowering costs and reinforcing accountability for taxpayer dollars,” said CMS Administrator Dr. Mehmet Oz. “We are cracking down on improper and misleading practices while giving states and health plans more room to innovate and compete. The goal is simple: lower costs, more choice, and Exchanges that work as intended.” Promoting Innovation in Plan Design The proposed rule encourages new, consumer-focused plan designs that expand choice and support affordability. Key proposals, if finalized, would: Allow issuers to offer catastrophic plans with terms of either one year or multiple consecutive years, up to ten years, aligning incentives for plans to invest in the long-term health of Americans. Repeal standardized plan options and related limit requirements, giving issuers greater flexibility to design plans that meet consumer demand. Permit low-deductible plans with higher maximum out-of-pocket limits to broaden affordable options. Better align affordability and coverage incentives across catastrophic and metal-level plans. Expand hardship exemptions for certain individuals age 30 and older in all states, allowing more consumers access to more affordable catastrophic coverage. Permit innovative, non-network plans to receive Qualified Health Plan certification by demonstrating sufficient provider choice. Strengthening Integrity and Accountability CMS proposes stronger eligibility and income verification, along with enhanced enforcement policies, to ensure premium subsidies are reserved for eligible individuals and to better protect consumers from improper enrollments and unauthorized plan changes. Additional income verifications will help reduce and prevent incidences of fraud across the Exchanges. The proposed rule would also update Exchange policies to reflect new legal requirements that limit eligibility for premium tax credits, cost-sharing reductions, and advance payments of those benefits to individuals who meet immigration eligibility standards and require Exchanges to verify that eligibility. The proposed rule also strengthens standards of conduct for insurance agents, brokers, and web-brokers by clarifying prohibited marketing practices and reinforcing oversight to deter fraud and misleading conduct. These steps are designed to bolster confidence in the Exchanges and protect consumers from bad actors. Driving Down Costs and Improving Affordability CMS also proposes updates to better align Exchange policy with statutory intent and address key cost drivers, including: Restoring fiscal discipline around Essential Health Benefits to ensure federal subsidies are not used to finance state-mandated benefits that increase costs for both consumers and taxpayers. Modernizing network adequacy and provider access reviews to improve transparency while reducing duplicative oversight. These reforms aim to lower premiums, improve access, and give consumers greater control over their health coverage decisions. The Trump Administration remains committed to maintaining stable, competitive, and affordable health insurance markets while ensuring federal programs operate with integrity and accountability. CMS welcomes public input on the proposed rule and looks forward to working with states, issuers, agents, brokers and stakeholders to finalize policies that put patients and taxpayers first. To review the proposed rule, visit https://www.federalregister.gov/d/2026-02769 . Public comments must be submitted by March 13, 2026. To review the proposed rule fact sheet, visit https://www.cms.gov/newsroom/fact-sheets/hhs-notice-benefit-payment-parameters-2027-proposed-rule . ### Get CMS news at cms.gov/newsroom , sign up for CMS news via email and follow CMS on Twitter @CMSgov Previous Newsroom Article Next Newsroom Article