2023-08635: Clarifying Eligibility for a Qualified Health Plan Through an Exchange, Advance Payments of the Premium Tax Credit, Cost-Sharing Reductions, a Basic Health Program, and for Some Medicaid and Children's Health Insurance Programs
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This proposed rule would make several clarifications and update the definitions currently used to determine whether a consumer is eligible to enroll in a Qualified Health Plan (QHP) through an Exchange; a Basic Health Program (BHP), in States that elect to operate a BHP; and for some State Medicaid and Children's Health Insurance Programs (CHIPs).
The agency’s own summary, as published.
What this changes
Amends 5 parts of the Code of Federal Regulations — the standing rules this notice rewrites.
- 42 CFR 435 Eligibility in the States, District of Columbia, the Northern Mariana Islands, and American Samoa
- 42 CFR 457 Allotments and Grants to States
- 42 CFR 600 Administration, Eligibility, Essential Health Benefits, Performance Standards, Service Delivery Requirements, Premium and Cost Sharing, Allotments, and Reconcilation
- 45 CFR 152 Pre-Existing Condition Insurance Plan Program
- 45 CFR 155 Exchange Establishment Standards and Other Related Standards Under the Affordable Care Act
Rulemaking docket
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