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HHS/CMS

RIN: 0938-AV23

Publication ID: Fall 2023

Title: Clarifying Eligibility for a Qualified Health Plan Through an Exchange, Advance Payments of the Premium Tax Credit, Cost-sharing Reductions, A Basic Health Program and Medicaid and CHIP (CMS-9894)
Abstract: This final rule makes several clarifications and updates to the definitions currently used to determine whether a consumer is eligible to enroll in a Qualified Health Plan (QHP) through an Exchange; a Basic Health Program (BHP), in States that elect to operate a BHP; and for some State Medicaid and Children’s Health Insurance Programs (CHIP). This rule modifies the definition of lawfully present to include Deferred Action for Childhood Arrivals (DACA) recipients, and makes additional technical modifications to the definition.
Agency: Department of Health and Human Services(HHS)	Priority: Section 3(f)(1) Significant
RIN Status: Previously published in the Unified Agenda	Agenda Stage of Rulemaking: Final Rule Stage
Major: Yes	Unfunded Mandates: No
CFR Citation: 45 CFR 152 45 CFR 155 42 CFR 435 42 CFR 457 42 CFR 600
Legal Authority: Pub. L. 111-148, secs. 1101 and 1331 42 U.S.C. 1302 42 U.S.C. 18021 to 18024 42 U.S.C. 18031 to 18033 42 U.S.C. 18041 and 18042 42 U.S.C. 18051 42 U.S.C. 18054 42 U.S.C. 18071 42 U.S.C. 18081 to 18083

Legal Deadline: None

Timetable:

Action	Date	FR Cite
NPRM	04/26/2023	88 FR 25313
NPRM Comment Period End	06/23/2023
Final Action	11/00/2023

Regulatory Flexibility Analysis Required: No	Government Levels Affected: Federal, State
Federalism: Yes
Included in the Regulatory Plan: No
RIN Data Printed in the FR: No
Agency Contact: Jeff Wu Deputy Director for Policy Department of Health and Human Services Centers for Medicare & Medicaid Services Center for Consumer Information and Insurance Oversight, MS: 733H.02, 7500 Security Boulevard, Baltimore, MD 21244 Phone:301 492-4305 Email: jeff.wu@cms.hhs.gov