As New ACA Exchange Rule Is Finalized, Insurers Are Already Facing Trouble

Jun 27
Jun 27, 2025

CMS on June 20 finalized a regulation that aims to tighten oversight of the Affordable Care Act exchanges but is also expected to add to the mounting headwinds facing the marketplace by making it tougher for people to get and stay covered.

And while provisions in that regulation won’t go into effect until at least 2026 — and enhanced ACA subsidies will not expire until the end of 2025 — some marketplace insurers are already facing troubles that will only be compounded once the policy environment worsens, one equities analyst recently observed.
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Leslie Small

Leslie has been working in journalism since 2009 and reporting on the health care industry since 2014. She has covered the many ups and downs of the Affordable Care Act exchanges, the failed health insurer mega-mergers, and hundreds of other storylines spanning subjects such as Medicaid managed care, Medicare Advantage, employer-sponsored insurance, and prescription drug coverage. As the managing editor of Health Plan Weekly and Radar on Drug Benefits, she writes and edits for both publications while overseeing a small team of reporters who also focus on the managed care sector. Before joining AIS Health, she was a senior editor for the e-newsletter Fierce Health Payer, and she started her career as a copy editor at multiple local newspapers. She graduated with a dual degree in journalism and political science from Penn State University.