The Right to Enroll Act of 2025 directs the Secretary of Health and Human Services to revise the federal regulation governing the annual open enrollment period so that the enrollment window for plan year 2026 begins November 1, 2025 and ends May 1, 2026. The instruction targets 45 C.F.R. §155.410(e) (or any successor regulation) and limits the change to the 2026 plan year.
The change expands the enrollment window well beyond the typical late-fall cutoff, creating a six-month period that spans before and after January 1, 2026. That shift matters operationally for Exchanges, issuers, navigators, and federal budget calculations for premium tax credits; it also raises implementation and actuarial questions for administrators and insurers who must adapt systems and effective-date rules.
At a Glance
What It Does
The bill directs HHS to revise the Code of Federal Regulations provision that sets the annual open enrollment period for Exchanges so the window covering plan year 2026 lasts six months. The instruction is regulatory—HHS must amend 45 C.F.R. §155.410(e) (or its successor) to set the enrollment period.
Who It Affects
Federally-facilitated and state-based Exchanges, health insurance issuers that sell qualified health plans on those Exchanges, consumer assistance programs and navigators, and people seeking individual market coverage — particularly those who enroll outside the traditional November–December rush.
Why It Matters
Extending the open enrollment period shifts when people can sign up and when premium tax credit flow and reconciliation occur, which affects enrollment volumes, issuer risk pools, and administrative schedules. Compliance officers, marketplace operators, and issuers will need to adjust notices, IT, and processes to align with a longer window.
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What This Bill Actually Does
The bill is short and narrow: it orders the Secretary of HHS to change the federal regulation that defines the annual open enrollment period for Exchanges so that, for plan year 2026, the period runs from early November 2025 through early May 2026. Congress does not change statutory subsidy rules, enrollment effective-date formulas, or special enrollment period criteria; it simply instructs the agency to set a different open-enrollment window via regulation.
Mechanically, HHS will have to issue a regulatory revision or other appropriate regulatory instrument to alter 45 C.F.R. §155.410(e) (or a successor provision). That action will cascade into operational tasks: Exchanges must update public notices, system deadlines, and enrollment flows; issuers must adjust their enrollment intake and coverage effective-date processing; navigators and consumer-assistance programs must recalibrate outreach plans to a longer enrollment season.Because the bill limits the change to the 2026 plan year, the extension is temporary by design.
However, a temporary regulatory change still affects how premium tax credits are applied and reconciled, how issuers estimate enrollment and set administrative processes for underwriting and claims, and how state-based exchanges coordinate with federal rules. The bill does not specify whether coverage elected during the post–January portion of the window would take effect retroactively to January 1 or follow the Exchanges’ existing effective-date rules—HHS will have to clarify that when it revises the regulation.Finally, the statute leaves several implementation choices to the agency: how to communicate effective dates to enrollees, whether to align state-based marketplaces automatically, and whether to adopt any transitional safeguards for issuers.
Those downstream decisions will determine whether the extended window simply spreads out enrollment demand or meaningfully changes who enrolls and when coverage becomes effective.
The Five Things You Need to Know
The bill requires the Secretary of Health and Human Services to revise 45 C.F.R. §155.410(e) (or any successor regulation) to set the open enrollment period for plan year 2026.
It fixes the plan year 2026 open enrollment window to begin November 1, 2025 and end May 1, 2026 — a six-month span that crosses the calendar-year boundary.
The directive applies only to the annual open enrollment period for plan year 2026; it does not amend the Affordable Care Act statute itself.
The bill instructs a regulatory change but does not specify coverage effective-date rules, premium tax-credit calculations, or whether state marketplaces must adopt the same dates.
There are no penalties, funding authorizations, or new programmatic grants in the bill — it is a single regulatory-direction statute with implementation left to HHS and Exchanges.
Section-by-Section Breakdown
Every bill we cover gets an analysis of its key sections.
Short title
Gives the Act the short title "Right to Enroll Act of 2025." This is purely nominal and carries no substantive duties or funding implications.
Directive to revise the federal open enrollment regulation
Directs the Secretary of HHS to revise 45 C.F.R. §155.410(e) (or any successor regulation) so that the annual open enrollment period for Exchanges for plan year 2026 begins on November 1, 2025 and ends on May 1, 2026. Practically, HHS will have to issue a regulatory amendment or other formal regulatory instrument and publish implementing guidance so Exchanges and issuers know enrollment deadlines and procedural changes.
Limited, plan-year-only change and regulatory implementation
The text confines the change to the 2026 plan year and does not amend statutory provisions in the Affordable Care Act (such as subsidy rules in 42 U.S.C. §18071). Because the bill prescribes dates but not operational mechanics (for example, when coverage becomes effective after enrollment), the rulemaking by HHS will need to resolve those gaps and decide whether and how state-based Exchanges will align their calendars.
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Explore Healthcare in Codify Search →Who Benefits and Who Bears the Cost
Every bill creates winners and losers. Here's who stands to gain and who bears the cost.
Who Benefits
- Uninsured and coverage-gapped individuals: A longer enrollment window gives people more time to learn about, compare, and enroll in qualified health plans, especially those who miss the traditional late-fall window.
- People experiencing income or employment churn: Larger, more flexible windows make it easier for people whose eligibility or need changes outside standard months to enroll without waiting for the next calendar year.
- Navigators and consumer-assistance programs: More months to enroll can spread outreach work over time and allow targeted campaigns to reach late movers or those hit by mid-winter life events.
- Some issuers seeking increased membership: Insurers could see higher enrollment volume (and premium revenue) from a longer season if outreach yields net new enrollees.
Who Bears the Cost
- HHS/CMS and Exchange operators: Agencies must update regulations, publish guidance, adapt IT systems and enrollment platforms, and run extended outreach — all administrative work with budget and staffing implications.
- Qualified health plan issuers: Carriers must handle altered intake timing, potential shifts in enrollment mix, and additional administrative processing to align effective dates and premium billing.
- Federal budget (premium tax credit administration): Extended enrollment timing could change the pace of subsidy disbursements and later reconciliation volumes, complicating fiscal management for Treasury and IRS.
- State-based marketplaces with differing timelines: States that prefer a different enrollment calendar may face coordination costs or user confusion if they do not align with the federal change.
Key Issues
The Core Tension
The central dilemma is between increasing access by giving prospective enrollees more time to sign up and preserving actuarial and administrative stability for issuers and Exchanges; expanding the window helps consumers who miss narrow deadlines but raises risks and costs that insurers and administrators must absorb or mitigate.
The bill solves the access problem by expanding the calendar window for enrolling, but it leaves numerous implementation details to HHS. The regulation revision must address effective-date rules for coverage elected after January 1, reconcile enrollment timing with premium payment schedules, and ensure that premium tax-credit application and reconciliation remain administrable.
Absent explicit language, HHS will need to decide whether post–January enrollments receive retroactive coverage or begin on a first-of-month basis, and that decision materially affects claims timing, insurer cash flow, and enrollee protections.
There is also an actuarial and selection risk trade-off. Extending enrollment into the months after plan-year start can increase adverse selection if people enroll only after incurring medical expenses; conversely, a longer window may capture healthier but late-deciding consumers and reduce concentration during a brief season.
The statute does not provide transitional funding or guardrails for issuers or Exchanges, so administrative cost recovery, IT upgrades, and consumer communications may fall to existing budgets unless HHS or Congress approves funding later.
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