Congress Moves to Scrap New ACA Marketplace Rules: What Happens When 'Affordability' Regulations Get Thrown Out?

This joint resolution is short, but its impact on healthcare regulations is anything but. Essentially, Congress is using a fast-track legislative tool—the Congressional Review Act (CRA)—to formally reject a new rule put forward by the Centers for Medicare & Medicaid Services (CMS). That CMS rule was titled "Patient Protection and Affordable Care Act; Marketplace Integrity and Affordability," meaning it was meant to adjust how the ACA exchanges work to ensure they stay stable and affordable for consumers.

The Administrative Rulebook Gets Tossed

Think of the CRA as Congress hitting the 'undo' button on the executive branch’s rulemaking. When Congress passes a resolution of disapproval like this, the targeted rule—in this case, the one published in Volume 90 of the Federal Register, starting on page 27074—is immediately nullified. It’s like the rule never existed. The practical effect is that whatever changes CMS was trying to implement regarding ACA marketplace operations, consumer protections, or cost management are now off the table, and the previous regulatory status quo remains in place.

Who Feels This Change?

Because the resolution targets a rule focused on "Marketplace Integrity and Affordability," the real-world consequences depend entirely on what that specific CMS rule contained. If CMS was trying to close loopholes that allowed bad actors to game the system, those loopholes might now remain open. If the rule was designed to streamline enrollment or curb excessive premium increases, those consumer benefits are now lost. For the millions of people who buy insurance through the ACA exchanges—from independent contractors to small business employees—the stability and cost of their plans are directly tied to these regulations. This action creates immediate uncertainty about the future direction of marketplace management.

The Oversight Double-Edged Sword

This move highlights the tension between legislative oversight and executive expertise. On one hand, Congress is asserting its authority to check the power of federal agencies like CMS. On the other hand, CMS typically issues these complex rules because they have detailed, data-driven insights into how the healthcare market is actually functioning. By scrapping the rule without providing an alternative framework, Congress risks creating a regulatory vacuum. If the overturned rule was genuinely aimed at stabilizing costs or protecting consumers, its removal could lead to increased market instability or confusion for insurers and state exchanges, potentially translating into higher premiums or fewer choices down the line for everyday people relying on the ACA for coverage.