CMS Seeks Reduced Health Insurance Premiums

The Centers for Medicare and Medicaid Services (CMS) released the 2025 Marketplace Integrity and Affordability Final Rule June 20. The agency said the rule’s provisions will decrease individual health insurance premiums by an average 5%. The rule focuses on improper enrollments in the Affordable Care Act (ACA) Exchanges and wasteful federal spending.

Major issues addressed in the rule include: encouraging continuous healthcare coverage rather than incentivizing Americans to enroll only when they become sick; a more stringent income verification processes for premium subsidies; removal of specified sex-trait modification procedures from essential health benefits; and exclusion of Deferred Action for Childhood Arrivals (DACA) from enrollment in ACA Exchange coverage.

CMS issued a fact sheet and press release with the rule. For questions about the Marketplace Integrity and Affordability final rule, contact Katie Keysor, American College of Radiology® Senior Director, Economics and Health Policy.