Stay ahead of ACA changes

Major changes to the Affordable Care Act could significantly impact how your agency operates. One thing is for certain, reaching out to your clients will be crucial to your success. 

This page is your go-to resource for tracking the latest information and getting tools, training, and support from HealthSherpa to help you navigate these changes with confidence. 

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POLICY UPDATES

DACA (Deferred Action for Childhood Arrivals) recipients no longer marketplace eligible

Effective: August 25, 2025

Special Enrollment Period ends for individuals at or below 150% FPL 

Effective: August 25, 2025

  • This change will restrict SEP eligibility for individuals unless they experience a Qualifying Life Event (QLE).

DMI (Data Matching Issue) is generated when tax data is unavailable

Effective: August 25, 2025

Expiration of enhanced subsidies (eAPTC)

Effective: January 1, 2026

  • Premium payments for subsidized enrollees will increase nationwide when eAPTC subsidies expire. eAPTC expiration will affect all FPL tiers.

Shorter Open Enrollment Period for PY27 (Nov 1, 2026 - Dec 15, 2026)

Effective: PY27

  • There will be no change to the annual Open Enrollment Period (OEP) for PY26.
  • OEP will shorten to Nov 1-Dec 15 with PY27.

 

Changes that were proposed in the CMS Final Rule but have not gone into effect:

  • DMI for certain income variances
  • SEP pre-enrollment verification
  • $5 premium for $0 passive renewals
  • Subsidy ineligible after one-year FTR
  • Past-due premiums can be required to effectuate
     

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