Dear Dan,

New Proposed Affordable Care Act Changes

Below is a list of the proposed changes. Please keep an eye out for our newsletter as we will keep you informed if and when these changes are made.

The monthly Special Enrollment Period (SEP) for individuals under 150% Federal Poverty Limit would be discontinued

• This change will restrict SEP eligibility unless the consumer experiences a Qualifying Life Event (QLE).

A new $5 monthly premium for fully-subsidized passive renewals

• Consumers eligible for $0 premium plans who don’t actively confirm their income may be required to pay $5/month until they verify.

Reinstatement of Failure to Reconcile (FTR) APTC eligibility restrictions

• Consumers will become ineligible for advance payments of the premium tax credit (APTC) if they didn't file their taxes and reconcile their APTC for one year (current regulations stipulate two years).

Shorter Open Enrollment Period (Nov 1–Dec 15 for PY26)

• The annual Open Enrollment Period (OEP) will be shortened to November 1–December 15 (currently OEP is November 1–January 15). These were the original dates when the Affordable Care Act was first put into place.

Resumption of SEP pre-enrollment verification

• If the Marketplace can’t verify your Special Enrollment Period, you may lose eligibility to enroll outside of Open Erollment. You will need to ensure you have proper documentation to avoid SEP verification issues.

President Trump Signs Executive Action to Lower Drug Prices

President Trump has issued an executive order to align prescription drug pricing with the "Most Favored Nation Pricing" model. Read more here.

Dan Walterman Receives Elite Circle of Champions Marketplace Recognition