CMS Proposes New Rules to Lower Health Care Costs and Expand Consumer Choice

The Centers for Medicare & Medicaid Services (CMS) has introduced a new proposal aimed at lowering health care costs, expanding coverage options, and improving transparency for consumers and taxpayers. The proposal is part of the 2027 Notice of Benefit and Payment Parameters, which outlines annual updates for the Affordable Care Act Marketplaces.

More Flexibility in Coverage Options

CMS is proposing to give insurers more room to innovate and design plans that better meet consumer needs. A major change would allow catastrophic health plans to last for more than one year—potentially up to ten years—offering longer-term stability for people seeking lower‑premium, higher‑deductible options. The proposal would also remove federal requirements for standardized plans, making it possible for insurers to offer more customized plan designs.

Improved Access to Catastrophic Coverage

Today, many adults over age 30 can only enroll in catastrophic coverage if they qualify for a hardship exemption. CMS aims to broaden these exemptions across all states, allowing more people to opt into this lower‑cost coverage type.

Strengthening Consumer Protections

The proposal places new focus on preventing misleading marketing and unauthorized plan switching by agents and brokers. CMS is also recommending stronger eligibility and income verification processes to ensure federal subsidies go only to individuals who qualify.

Encouraging Innovation and Competition

For the first time, CMS is considering allowing certain non‑network health plans to be certified as Marketplace plans if they can show consumers will still have access to an adequate choice of providers. CMS believes this could lower administrative costs and introduce additional plan options that may improve affordability. 

How These Changes Could Affect Insurance Agents

If finalized, these rules could bring noticeable adjustments for insurance agents. Stronger oversight of marketing practices may require agents to follow updated compliance steps and use standardized consent documentation when assisting clients. At the same time, expanded flexibility in plan design—such as longer-term catastrophic plans and potential new non‑network options—could give agents more variety to offer consumers. While this may mean learning new products and staying on top of regulatory changes, it also creates opportunities to match clients with coverage that fits their needs more precisely. Overall, agents may see a combination of added compliance responsibilities and increased plan options to support their customers.

Next Steps

These changes are currently proposed and open for public comment. If finalized, they would take effect for the 2027 plan year. CMS states that the goal is to make coverage more affordable, expand meaningful choices, and strengthen accountability across the Marketplace.