# Federal Register #CMS-9873-P

CMS proposed rule on Exchange eligibility verification and enrollment

**Buyer:** Centers for Medicare & Medicaid Services (CMS), U.S. Department of Health and Human Services
**Posted:** October 27, 2026
**Respond By:** November 27, 2026
**Identifier:** CMS-9873-P

CMS proposes regulatory changes to Affordable Care Act Exchange eligibility and enrollment verification; this notice is not a request to buy products or services.
- **Government buyer:** No purchasing agency is identified. The issuing agency is the Centers for Medicare & Medicaid Services (CMS), within the U.S. Department of Health and Human Services (HHS).
- **Proposal scope:** Changes would address eligibility data-matching issues, residency verification, annual and in-plan-year eligibility redeterminations, enrollment while verification is underway, coverage effective dates, and State Exchange readiness before open enrollment.
- **Notable requirements under consideration:** CMS proposes limits on authorizing advance premium tax credits and cost-sharing reductions while specified data-matching issues remain unresolved. The proposal also seeks input on improving residency verification while protecting consumers.
- **Organizations mentioned:** LexisNexis is cited as a provider used in a prior residency-verification pilot. The Internal Revenue Service (IRS) and data brokers are discussed as possible verification approaches, not as selected vendors.
- **Procurement status:** No products, services, quantities, part numbers, or contract value are identified.

### Description

This proposed rule would implement Working Families Tax Cut legislation requirements related to Exchange eligibility and verification. It proposes updates to inconsistency periods and verification procedures, annual and in-plan-year eligibility redeterminations, and enrollment methods during the verification process. It also proposes new coverage effective dates and includes proposals concerning State Exchange pre-open enrollment verification and related eligibility rules. Comments must be received by November 27, 2026.

[View original listing](https://www.federalregister.gov/documents/2026/10/27/2026-21891/patient-protection-and-affordable-care-act-exchange-pre-eligibility-verification)