Providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Centers for Medicare & Medicaid Services relating to "Patient Protection and Affordable Care Act; Marketplace Integrity and Affordability".
Introduced September 17, 2025 · Last action September 17, 2025
Plain English Summary
This bill uses a Congressional Review Act (CRA) procedure to reject a June 2025 Centers for Medicare & Medicaid Services rule on marketplace integrity and affordability under the Affordable Care Act. If passed, the rule would be canceled and cannot be reissued in substantially the same form without new Congressional authorization.
Who benefits
Health insurers and ACA marketplace carriers who oppose tighter enforcement of marketplace rules; insurers seeking to reduce compliance burdens; potentially employers and individuals currently subject to the rule's integrity or affordability requirements that the rule imposed.
Who pays / loses
Individuals enrolled in ACA marketplace plans who rely on the integrity and affordability protections the rule provides; uninsured persons who benefit from marketplace stability; state insurance commissioners enforcing marketplace rules; CMS staff and state health officials who administered the rule.
Funding & Lobbying Interests
Health insurance industry associations and carriers that oppose CMS marketplace enforcement rules (America's Health Insurance Plans, Blue Cross Blue Shield Association, and regional insurers) typically lobby against enhanced marketplace integrity measures. The rule itself addresses 'integrity and affordability,' suggesting prior industry opposition to CMS enforcement initiatives. Sponsor Mrs. Sykes's donor data was not provided, so specific campaign finance ties cannot be detailed.
Political Impact
Affected Groups
Approximately 21.8 million individuals currently enrolled in ACA marketplace plans (as of 2024 open enrollment); low-income and middle-income enrollees relying on subsidies and protections afforded by marketplace rules; uninsured persons in states where the marketplace functions as a primary coverage pathway; small employers participating in SHOP (Small Business Health Options Program).
Political Subtext
Proponents argue the rule imposes unnecessary compliance burdens on insurers and increases costs passed to consumers. Critics contend the rule protects marketplace consumers from predatory practices, fraud, and coverage gaps; that rejecting it weakens insurance market oversight and destabilizes coverage for millions. Non-partisan evidence on this specific June 2025 rule is unavailable, but CRS and CBO historically find that CMS marketplace rules aim to reduce adverse selection and insolvency risk, and that weakening enforcement correlates with higher uninsured rates in affected markets.
Real-World Stakes
If enacted, the 2025 marketplace integrity rule expires, and CMS cannot enforce the specific requirements it contained without Congressional approval. Insurers gain regulatory relief; marketplace participants lose protections the rule created. The analogous precedent is the 2017 CRA rejection of a 2016 CMS rule on health plan payment policies—after that rejection, insurers gained more pricing flexibility but some states reported market exits by smaller carriers. The Congressional Budget Office does not cost CRA disapprovals, as they reverse rules rather than create new spending.
Sponsor
Sponsor information not available.
Vote Record
No recorded votes.
Campaign Finance — Primary Sponsor
No campaign finance data available yet.
501(c)(4) disclosure: Contributions from 501(c)(4) "dark money" organizations are not required to be publicly disclosed and are not reflected in the figures above. Data sourced from FEC public disclosure filings.
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