By Sabrina Corlette, Jason Levitis, Lindsey Murtagh, and Claire O’Brien
On February 11, 2026, CMS published the proposed 2027 Notice of Benefit and Payment Parameters (NBPP), which serves as the primary annual regulation governing coverage under the Affordable Care Act (ACA). This proposal introduces significant changes to the ACA’s insurance standards and Marketplace operations, including higher net premiums and new paperwork requirements for Marketplace applicants. Analysis from researchers at the Urban Institute, Georgetown University’s Center on Health Insurance Reforms, and Brown University’s Center for Advancing Health Policy Through Research suggests these provisions could result in a reduction in enrollment of four million people or more while increasing administrative costs for Marketplaces and insurers by over $600 million in 2027.
To better understand how these proposals intersect with existing statutory requirements and recent judicial decisions, a fact sheet and their full comment letter are now available for download.
