Health Insurance Rule Changes on Hold: What It Means for 2026 Coverage

If you’ve been preparing for upcoming ACA Marketplace regulatory updates, you can take a breath. Following a federal court ruling in City of Columbus v. Kennedy, several major proposed CMS rule changes have been temporarily placed on hold while litigation moves forward.  

Here is what this court stay means for your daily operations, your enrollment workflows, and your clients.

The Big Takeaway: Do not alter your day-to-day enrollment processes. Because the court issued a stay on CMS's proposed regulations, previous Marketplace rules remain fully in effect until the lawsuit is resolved.  

💡 Quick Primer: Law vs. Regulation vs. Guidance

To understand why these rules are on hold, it helps to distinguish how policy operates:

Policy Type	What It Is	Current Status
Federal Law	Passed by Congress (e.g., One Big Beautiful Bill Act).	In Effect. Only Congress or a constitutional court ruling can change federal statutory laws.
CMS Regulations	Agency rules detailing how laws are carried out.	PAUSED. Specific proposed regulations are currently frozen by the federal court stay.
CMS Guidance	Bulletins/FAQs explaining rule implementation.	Active. Updated regularly by CMS to reflect court orders and operational procedures.

🛑 What Proposed Changes Are Currently Paused?

Until litigation concludes, CMS is blocked from implementing the following proposed changes. Existing rules remain active for each:

• Failure to File & Reconcile (FTR): The proposed 1-year FTR rule is paused. Exchanges cannot deny or remove Advanced Premium Tax Credits (APTC) under this proposal.  

• Open Enrollment Period (OEP): The proposed shorter Open Enrollment window is on hold. Standard OEP timelines remain in place.

• Income Verification: Proposed updates to income documentation requirements are frozen; standard verification processes continue.

• Special Enrollment Period (SEP) Verification: Existing SEP eligibility checks and enrollment rules apply.

• Expanded Bronze Plan Out-of-Pocket Limits (MOOP): Proposed out-of-pocket expansion is paused; standard cost-sharing limits stay as-is.

• Income-Based Hardship for Catastrophic Plans: Proposed expansion for catastrophic plan eligibility is on hold.  

• Network Adequacy & Provider Reviews: Current federal network standards, Essential Community Provider (ECP) reviews, and provider access requirements remain unchanged.

• Plan Certifications & Limits: Standardized plan options, non-standardized plan limits, and non-network QHP certification requirements remain under existing rules.  

📋 What Brokers Should Do Now

1. Business as Usual: Continue advising and enrolling clients using current, active Marketplace rules.

2. Remember It’s Temporary: These proposed changes haven't been permanently eliminated, they are simply frozen during litigation.

3. Stay Alert: Appeals or further court orders could change the landscape again. We will continue monitoring CMS updates and notify you as soon as actionable changes are required.