Healthcare Facilities & Managed Care "2027 Final Exchange Rules" Rice

Research evidence excerpt

Healthcare Facilities & Managed Care "2027 Final Exchange Rules" Rice

Global Research

18 May 2026ab

Healthcare Facilities & Managed Care Equities

Americas2027 Final Exchange Rules

Healthcare Providers

AJ Rice

Finalized Rules See Decline in Enrollment for 2027 Analyst

On Friday (5/15), CMS finalized the 2027 Notice of Benefit and Payment parameters for aj.rice@ubs.com

the public exchanges. CMS continues to expect a 1.2-2.0 mln enrollment decline in +1-212-713 4299

2027 from the finalized rules. The total decline through 2030 is expected to be 2.0-5.2 Jonathan Yong

mln, a slight improvement relative to the 2.2-5.4 mln in the proposed rules. Note, CMS Analyst

increased its expected baseline enrollment for 2026 to 18.861 mln vs 17.71 originally jonathan.yong@ubs.com

based on enrollment activity seen thus far. CMS is lowering user fees on both the federal +1-212-713 6268

and state based exchanges. The fees move to 1.9% (was 2.5%) on the federal Michael Wei

exchanges and 1.5% (was 2.0%) on the state exchanges. OSCR and CNC are the most Associate Analyst

exposed to the exchanges. michael.wei@ubs.com

+1-212-713 2565

Finalized Rules James Kurek

Other rules being finalized include: Analyst

james.kurek@ubs.com

CMS is discontinuing the requirement for issuers to offer standardized plan +1-212-713 3704

options and removing the limits of non-standardized plan options. Joseph Overman

CMS is finalizing, beginning in 2028, a change to allow issuers offering non- Associate Analyst

joseph.overman@ubs.com

network plans to receive certifications to be offered as a qualified health plan

+1-212-882 0086

through the Federal Exchanges.

CMS is finalizing allowing individuals who are ineligible for ATPCs or CSRs due to

income to qualify for hardship exemption to enroll in catastrophic plans.