The premium tax subsidies that allow lower-income individuals to get Affordable Care Act (ACA) health insurance free or at reduced cost are scheduled to expire at the end of 2025. If the current subsidies do expire, millions of low-income individuals will face significant health insurance cost increases. Extension of the subsidies will be a key issue in the 2025 tax bill and/or during the November-December lame-duck session of the 118^th Congress.

On October 5, the Centers for Medicare and Medicaid Services (CMS) released its proposed rules for Affordable Care Act (ACA) health insurance for 2026. The rules cover agent/broker practices.

On July 25, Senate Finance Committee Chair Sen. Ron Wyden (D-OR), along with five colleagues, introduced legislation that would impose criminal penalties on “rogue” health insurance advisors who make changes to individuals’ Affordable Care Act (ACA) health insurance without the insureds’ knowledge or consent. The Insurance Fraud Accountability Act would impose fines on brokers who negligently provide incorrect enrollment information, and criminal liability if the provision of incorrect information is “knowingly and willfully false or fraudulent.”

On March 28, the Departments of Labor (DOL), Health and Human Services’ (HHS’) Centers for Medicare and Medicaid Services (CMS), and Treasury released a final short-term limited-duration (STLD) health insurance rule. It retains the proposed rule’s new limits of three months duration, with a four-month renewal option for this kind of insurance.

The Centers for Medicare and Medicaid Services (CMS) has announced new cost-sharing limits and required contribution percentages for the 2025 benefit year. For the 2025 calendar year, the self-only coverage annual limitation on cost-sharing is $9,200. It is $18,400 for other than self-only coverage.