The federal government is proposing that Obamacare health insurance marketplaces verify applicants' income, citizenship or immigration status, other health coverage, and place of residence before providing financial assistance. In other words, Obamacare subsidies would require prior eligibility verification starting with the 2028 coverage year. The Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), issued the proposal on October 23, according to its fact sheet.
Why it matters: Currently, when a marketplace cannot verify information electronically, the applicant enters an «inconsistency period» to submit supporting documents while continuing to receive advance payments of the premium tax credit (APTC) and cost-sharing reductions (CSR). The proposed Obamacare eligibility requirements would change this process. The proposed rule estimates that approximately 332,500 fewer people would enroll annually across all marketplaces (237,500 in marketplaces using the federal platform and 95,000 in state-based marketplaces) due to administrative barriers.
The proposal, identified as CMS-9873-P, would align marketplace rules with the Working Families Tax Cuts (WFTC) law, which changed premium tax credit requirements, and with Treasury Department regulations proposed on October 15, 2026. You can review the proposed rule in the Federal Register, which is scheduled for official publication on October 27. Under the proposed Obamacare subsidy verification requirements, marketplaces would have to verify the following before providing financial assistance:
During the inconsistency period, applicants could enroll in a health insurance plan without financial assistance, paying the full price while their eligibility is verified. They could also select a «contingent plan,» which would take effect only if they are confirmed eligible for assistance, even if the open enrollment period or their special enrollment period has ended. CMS says the proposal aims to reduce ineligible or fraudulent enrollments and the risk of applicants having to repay excess premium tax credits when filing their taxes.
Obamacare enrollees would only be automatically re-enrolled with financial assistance if they return to the marketplace each year to confirm certain eligibility information and have it verified again. Those who do not complete this annual verification process would be automatically re-enrolled without financial assistance.
A new eligibility verification period would begin before open enrollment on August 1 each year. The first would start on August 1, 2027, for Obamacare coverage in 2028. The new requirements would not apply to applicants qualifying for a special enrollment period due to birth, adoption, marriage, or loss of a dependent through divorce, separation, or death, if permitted by the marketplace. This is a proposed rule, not a final regulation, and it would not affect 2027 coverage.
Source: CMS fact sheet CMS-9873-P and Federal Register. Data consulted on October 26, 2026.
