NEWS: ACA Update - CMS Confirms APTC Protection and January 15 OEP Deadline

CMS has released important guidance that could significantly affect how agents prepare for the 2027 ACA Open Enrollment Period.

Following federal court rulings in City of Columbus v. Kennedy, CMS has confirmed changes involving Failure to File and Reconcile (FTR), income verification timelines, and the 2027 Open Enrollment Period.

BIG NEWS

Here is what agents need to know.

1. FTR will not cause consumers to lose APTC for Plan Years 2026 or 2027

FTR stands for Failure to File and Reconcile.

Consumers who receive an Advance Premium Tax Credit (APTC) are still required to file a federal income tax return and reconcile the premium tax credit they received using Form 8962 and the information provided on Form 1095-A.

However, CMS now states that, for Plan Years 2026 and 2027, Exchanges must stop denying or removing APTC because a consumer failed to file and reconcile premium tax credits from prior years.

For agents, the key takeaway is:

A consumer’s FTR status alone should not result in the denial or removal of APTC for Plan Years 2026 or 2027.

This provides important protection for consumers who may otherwise have experienced a significant premium increase or loss of financial assistance due to an unresolved FTR status.

Important: Consumers must still file and reconcile

This guidance does not eliminate the requirement to file a federal tax return and reconcile APTC.

Agents should not tell consumers that they no longer need to reconcile. Instead, use the following guidance:

“Failure to reconcile will not currently cause the Marketplace to remove your APTC for Plan Years 2026 or 2027. However, you are still required to file your federal taxes and reconcile your premium tax credit.”

This distinction is critical when educating consumers.

2. The previous two-year FTR policy is no longer valid

CMS has also confirmed that its previous guidance regarding the two-year FTR policy is no longer valid for Plan Years 2026 and 2027.

Previously, the Marketplace operated under a framework in which households could face the loss of APTC after failing to file and reconcile for the required period. CMS had also issued warning notices to some potentially affected consumers.

For Plan Years 2026 and 2027, agents should not frame the issue as a one-year versus two-year FTR question.

The updated guidance is broader:

For these plan years, FTR itself should not be used as the basis for denying or removing APTC.

3. The automatic 60-day income inconsistency extension is back

CMS also confirmed that HHS has reinstated the automatic 60-day extension for consumers working to resolve certain household-income data inconsistencies.

These situations can occur when the income reported on a Marketplace application does not match available government data.

The restored extension gives affected consumers additional time to submit documentation and resolve an income data-matching issue.

For agents, this means more time may be available to help clients provide the required information and complete the verification process.

4. HealthCare.gov Open Enrollment will run November 1–January 15

CMS has confirmed that Open Enrollment for the Federally-facilitated Marketplace, including HealthCare.gov, will begin on November 1, 2026, and end on January 15, 2027.

2027 HealthCare.gov Open Enrollment Period

November 1, 2026–January 15, 2027

This restores an additional month of enrollment opportunity beyond the previously anticipated December 15 end date.

For agents serving consumers through HealthCare.gov, this is an important planning update that provides additional time to:

• Connect with new and returning consumers

• Follow up with clients who have not completed enrollment

• Resolve application or documentation issues

• Support consumers as they evaluate coverage options

Why this matters

These changes provide important protections and additional flexibility heading into the 2027 ACA selling season.

The most important message for agents is:

• Consumers will not lose APTC for Plan Years 2026 or 2027 solely because of FTR status.

• Consumers must still file their taxes and reconcile any APTC received.

• The automatic 60-day extension for certain income data inconsistencies has been restored.

• HealthCare.gov Open Enrollment will run from November 1, 2026, through January 15, 2027.

CMS has indicated that additional guidance may be issued as other provisions affected by the City of Columbus litigation continue to develop.

TBI will continue monitoring CMS updates and share additional information that may affect the 2027 ACA selling season.