2026-14709RuleSignificantWallet

ACA Rulebook Gets Minor Spelling Fixes for 2027

Published Date: 7/21/2026

Rule

Summary

This correction fixes some typos and technical mistakes in the 2027 health insurance rules under the Affordable Care Act. It mainly affects people and organizations involved in health coverage plans by clarifying when the rules take effect and restoring some important regulation details. These fixes take effect on July 20, 2026, ensuring smoother and clearer health plan operations next year.

Analyzed Economic Effects

2 provisions identified: 2 benefits, 0 costs, 0 mixed.

States Must Pay for Extra Benefits

The rule reinstates paragraph (a)(3) of Sec. 155.170 that says a State must make payments, under paragraph (b) of that section, to help pay the cost of any State-required benefits that are in addition to the essential health benefits (EHB). This reinstatement is made in the 2027 Notice of Benefit and Payment Parameters and becomes effective July 20, 2026.

Which State Benefits Count As EHBs

The rule clarifies when State-required benefits count as essential health benefits (EHB) versus being "additional" benefits. For plan years beginning before January 1, 2028, benefits required by State action on or before December 31, 2011, or required for Federal compliance, or included in the State's EHB-benchmark plan are EHB; benefits required by State action on or after January 1, 2012 that are not in the benchmark are additional. For plan years beginning on or after January 1, 2028, a State may require additional benefits only if they (i) stem from State action after December 31, 2011, (ii) apply to small group and/or individual markets, (iii) are specific to required care/treatment/services, and (iv) are not required for Federal compliance.

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Key Dates

Rule Effective
Published Date
7/20/2026
7/21/2026

Department and Agencies

Department
Independent Agency
Agency
Health and Human Services Department
Centers for Medicare & Medicaid Services
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