Still Covered: What the New Marketplace Rule Means (and Doesn’t Mean) for Your 2025 Health Plan

There’s been a lot of buzz about the new Marketplace Integrity and Affordability Rule and the One Big Beautiful Bill Act, and we understand it might feel a little overwhelming. But here’s the most important thing to know right now:

👉 If you’re already enrolled in a Marketplace health plan, your coverage is not changing.

If all your income and immigration verifications are cleared, and you’ve filed your taxes for 2023 and 2024, your plan will continue as normal—no immediate action required.

But for some individuals, there are a few important things to keep in mind as we move into this new phase of stricter oversight.

Who Needs to Pay Extra Attention?

1. Immigrants with Pending or Expiring DocumentsIf you’re not lawfully present in the U.S. or your immigration status is set to expire soon and you haven’t submitted updated documents, your eligibility for coverage and subsidies could be at risk under the new rule. The Marketplace is now flagging more applications based on immigration and legal presence, so staying current with your documentation is critical. If you have updated your documents, or received a new immigration status, let your agent know so we can submit the most up to date documents to the Marketplace.

2. Tax Filers Who Haven’t Submitted 2023 TaxesThe government is data-matching your Marketplace application with your tax returns. If you haven’t filed your 2023 taxes (especially if you received subsidies), your plan could be flagged and your premium assistance may be removed. This could result in a much higher monthly premium—or even loss of coverage. Later in the year, they will also be looking at your 2024 tax return to ensure that you have filed for the most recent calendar year as well. They will also be checking to see if your income estimate on your current plan matches what your 2024 adjusted gross income is. If there is a large difference in those numbers, you may be required to show proof of why there is such a large difference. 

We’re Watching Closely—But Stay Alert

Here at Utah Avenue Insurance, we are keeping a close eye on all our clients’ plans and any new updates that come through. That said, the government can make adjustments at any time.

📬 If you receive a letter from the Marketplace or HealthCare.gov that you don’t understand—especially anything about your income, taxes, or immigration status—call your agent immediately. We’re here to help you respond quickly, submit documents for you, and keep your plan active.

💬 Need help checking your documents that you need to submit for  immigration status or tax filing status?Don’t go it alone. Let your local experts at Utah Avenue Insurance guide you through the process. We can submit the right documents for you and watch to make sure the Marketplace clears those verifications and let you know if they need more information. 

🛡️ Better coverage starts here.