The Trump administration's final ACA rule introduces non-network plans and higher out-of-pocket maximums for bronze and catastrophic plans starting in 2027-2028. The changes aim to expand choices but could reduce enrollment by up to 2 million next year.
- Non-network plans require consumers to find providers accepting insurer payment as full reimbursement. - Bronze plan out-of-pocket maximums may reach $15,600 for individuals and $31,200 for families.
- Eligibility verification is tightened, including one-year tax filing requirement for premium tax credits. - Legal challenges continue from cities and other plaintiffs.
The rule is expected to erode marketplace access and affordability, particularly for lower-income enrollees.