In February 2026, the Centers for Medicare & Medicaid Services (CMS) unveiled a major proposed change to the way health insurance plans are offered on the Affordable Care Act (ACA) exchanges. After several years of rules designed to simplify consumer choice by limiting the number of non-standardized plan options, CMS is now proposing to roll back those limits and give insurers greater flexibility in plan design and offerings. This marks a significant shift in policy and has generated discussion across the healthcare policy world.
A Bit of Background: What Are Non-Standard Plans and Why Were Limits Introduced?
Under the ACA, health plans offered on federally facilitated marketplaces — commonly known as HealthCare.gov — have traditionally come in thousands of variations. These include standardized plans, which have set cost-sharing features that make them easier to compare, and non-standard plans, which allow insurers to innovate with benefit designs, pricing, and provider networks.
In recent years, CMS adopted regulations that severely limited the number of non-standardized plan options that any insurer could offer in a given metal tier (such as bronze, silver, or gold) and service area. By 2025, this limit was set at two non-standard plans per metal level. The aim was straightforward: reduce “choice overload” for consumers. With plan options in some markets ballooning from around 27 per region to well over 130, policymakers worried that too much choice was making it harder, not easier, for consumers to select the best plan for their needs. Simplifying the marketplace was intended to streamline decision-making and boost enrollment in plans that balanced affordability with transparent benefits.
The New Proposed Rule: Rolling Back Limits
CMS’s 2027 Notice of Benefit and Payment Parameters introduced in February 2026 makes a bold proposal: eliminate the existing limits on non-standardized plan options altogether and also drop the current requirement that insurers offer standardized plan options. Instead, insurers would be given the choice to continue offering standardized plans if they believe these benefit their consumers — but they would not be forced to do so. CMS says this approach will “reduce issuer and HHS burden and regulatory complexity and enhance flexibility for issuers to innovate in plan design.” In other words, carriers will have more freedom to tailor plans to specific populations and needs without being constrained by the current caps.
Alongside this change, CMS also proposes other adjustments to the market, such as offering longer-term catastrophic coverage options and allowing plans with certain trade-offs between deductibles and out-of-pocket maximums. These proposals are intended to give insurers room to offer a broader array of options and respond to consumer demand where it exists.
Support and Criticism: Two Sides of the Debate
The shift has sparked mixed reactions. Proponents of the rollback argue that the strict limits stifle innovation and prevent carriers from offering creative solutions for subsets of patients who may benefit from specialized designs. For example, plans targeted to people with chronic conditions — such as diabetes-focused plans with enhanced coverage for diabetic care — may not have been viable under the old limits. Removing caps could encourage insurers to develop offerings that better address unique health needs.
Critics, however, raise concerns about returning to an era of plan proliferation that can confuse and overwhelm consumers. One of the original motivations for limits was to make plan shopping more straightforward and prevent people from feeling buried under a deluge of nearly identical yet subtly different options. Simplified plan menus can make comparison shopping easier and help consumers make choices aligned with their health and financial priorities.
Implications for Consumers and the Market
What does this mean for everyday users of the ACA marketplaces? If CMS finalizes the rollback in its current form, consumers could see a wider variety of plans available in upcoming open enrollment periods. This could be a double-edged sword: greater choice might mean better matching of coverage to individual preferences or needs, but it might also reintroduce the very complexity that CMS once sought to tame.
Furthermore, this policy shift comes at a time when broader debates about ACA subsidies and eligibility are underway elsewhere in federal policy. As lawmakers and regulators wrestle with affordability issues and market stability, the contours of the ACA exchange landscape continue to evolve.
Conclusion: Flexibility Versus Simplicity
CMS’s proposal to roll back limits on non-standardized ACA plan options reflects a broader tension in health policy: the balance between flexibility for innovation and simplicity for consumer clarity. While removing the caps may empower insurers and potentially expand choices for certain populations, it also raises questions about how consumers will navigate those choices effectively. As the rulemaking process unfolds, stakeholders from insurers to consumer advocates will be watching closely to see how these competing priorities play out in future marketplace offerings.