Project 2025 Tracker / What’s done, what’s next

14. Department of Health and Human Services · Notable

Separate the subsidized ACA exchange market from the non-subsidized market

Not started

469 14. Department of Health and Human Services · abridged

“Separate the subsidized ACA exchange market from the non-subsidized insurance market. … CMS should develop a plan to separate the non-subsidized insurance market from the subsidized market, giving the non-subsidized market regulatory relief from the costly ACA regulatory mandates.”

What has happened

  1. Not started

    CMS has developed no plan to separate the non-subsidized from the subsidized market, and the non-subsidized market has been given no relief from the ACA's benefit mandates. The two rules that reshaped the exchanges in the window — Marketplace Integrity and Affordability (final 2025-06-25) and the 2027 Payment Notice (final 2026-05-20) — work in the opposite direction, tightening eligibility verification and enrolment periods inside a single risk pool; "non-subsidized" appears in the 2027 Payment Notice only in commenters' warnings that healthy unsubsidized enrollees will leave. Negative search recorded in `docs/research/ch-14.md` under the round-2 (ticket 16) cluster searches.

    No action found yet. This entry is the starting point, not a finding.

Research log

What was searched, and what didn’t count as evidence

Research notes

  • Queries: Federal Register “non-subsidized” since 2025-01-20 → 2 documents (the 2027 Payment Notice and its proposal), both in comment summaries; the full text of the Marketplace Integrity and Affordability final rule (FR 2025-11606) was fetched and searched. Among the bills we keep and search, from congress.gov, a search for market separation → nothing.
  • Single risk pool requirements come from ACA § 1312(c) and 45 CFR 156.80; neither was amended.
  • HHS regulatory agenda, checked 2026-09-01. Checked against the full HHS agenda on reginfo.gov (183 active RINs in the 2026 Unified Agenda, published 2026-08-14), not the abbreviated version the Federal Register prints. The nearest entry is recorded here. It does not name this ask’s object, so the Status did not change: an agenda entry counts as an attempt only when it names what the ask asks for.
    • Three ACA entries widen alternatives to exchange coverage without separating the two markets: 0938-AV92 (Short-Term, Limited-Duration Insurance, CMS-9881, NPRM 08/2026), 0938-AW00 (Expanding Access to Individual Coverage Health Reimbursement Arrangements, CMS-9876, NPRM 07/2026) and 0938-AV99 (State Innovation Waivers and Health Care Choice Compacts, CMS-9877, NPRM 07/2026). AV92’s abstract names the problem the Quote names — people ineligible for premium tax credits facing individual-market premiums — and answers it by loosening the STLDI definition, not by giving the non-subsidized market relief from the ACA mandates.
Action
other
Object
subsidized and non-subsidized ACA insurance markets
ID
1291