Final ACA Marketplace Rule Delivers Another Blow to Families by Further Eroding Access to Affordable, Quality Health Coverage

05.18.2026 / Statement

Rule Allows for Higher Deductibles, No-Network Plans, and More Junk Insurance.

WASHINGTON, D.C. - In response to regulatory changes made to the individual insurance marketplaces under the Affordable Care Act (ACA) in the 2027 final rule for the Notice of Benefit and Payment Parameters (NBPP) released by the Centers for Medicare & Medicaid Services (CMS), Families USA, the longtime health care consumer advocacy organization, issued the following statement by its executive director, Anthony Wright:

"The Trump administration just made health care harder to afford, harder to access, and harder to keep - and millions of Americans who rely on the ACA marketplaces for coverage will pay the price.

"The bottom line of these regulatory changes is clear: more barriers to care, fewer consumer protections, skimpier benefits, sky high deductibles and narrower networks. Consumers will have to pay more for worse coverage. Enrollment will get harder and consumer protection safeguards will weaken. This new rule also codifies the harmful changes made by the Republican health care cuts included in H.R. 1, such as taking away affordable coverage from many lawful immigrants.

"The details of this final rule include allowing even higher deductibles, and to permit plans with no networks. This rule further opens the door to junk plans that leave people unable to access the care they actually need - all while driving up the cost of real, comprehensive coverage for everyone else.

"The new rule makes it harder to shop, compare, and sign up for coverage. The rule eliminates standardization of plans, which is the benchmark that allows consumers to comparison shop. Special enrollment periods will be more restricted, creating new gaps in coverage for people experiencing life changes. And lawfully present immigrants living below the poverty line are cut off from the affordability assistance available to others.

"This rule is the latest in a relentless assault on American families' access to health care - following the largest cuts to Medicaid in history - going back on years of coverage gains. Congress must act now and stand up for their constituents who want lower health care costs. People want Congress to cut costs, not coverage or care. We want to cut red tape, not double down on the bureaucratic barriers designed to push people off coverage. We urge Congress to act to undo this final rule's wrongs by prioritizing sensible health care policies and reforms that strengthen health coverage and accessibility for all - especially the most vulnerable and underserved populations.

"While most of the final rule will make coverage worse and harder to obtain, we appreciate that the final rule did impose new crackdowns on predatory broker practices and the rule did not finalize a proposal to increase Enhanced Direct Enrollment (EDE), which would have allowed state marketplaces to entirely hand over their operation to third-party platforms.

"We will continue fighting to protect families' health and financial security. Everyone - regardless of where they live, how much money they make, or where they come from - deserves access to affordable, high-quality health care."