CMS Finalizes Major Changes to ACA Exchanges, Expanding Catastrophic Plan Access

The Centers for Medicare & Medicaid Services finalized major changes to Affordable Care Act exchanges on May 19, 2026, under the Trump administration. The rule significantly expands access to catastrophic plans with high deductibles, described as cheap coverage options. Insurance experts and healthcare stakeholders raised concerns about coverage adequacy under the expanded catastrophic plan access.

Catastrophic plan access expansion

• ▪The Centers for Medicare & Medicaid Services finalized major changes to Affordable Care Act exchanges that include greater access to catastrophic plans.
• ▪The Trump administration is expanding access to catastrophic plans on Affordable Care Act exchanges.

Industry stakeholder concerns

• ▪Catastrophic plans on Affordable Care Act exchanges are characterized as cheap, high-deductible coverage.
• ▪The Trump administration is opening the doors to cheap, high-deductible coverage on Affordable Care Act exchanges.
• ▪Insurance experts are worried about the Trump administration's expansion of catastrophic plan access on Affordable Care Act exchanges.

Perspective of Insurance experts and healthcare stakeholders

• ▪Insurance experts are concerned that expanded catastrophic plan access on Affordable Care Act exchanges may result in inadequate coverage for enrollees.

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