On February 9, 2026, the Centers for Medicare & Medicaid Services (CMS) released a proposed rule entitled, Patient Protection and Affordable Care Act, Benefit and Payment Parameters for 2027 and Basic Health Program. The proposed rule sets standards for the Health Insurance Exchanges and for health insurance issuers, brokers, and agents operating under the Affordable Care Act (ACA). This proposed rule also includes amendments to implement certain provisions of the One Big Beautiful Bill Act. Of note, CMS proposes to prohibit issuers from including routine non-pediatric dental services as an Essential Health Benefit (EHB). The agency notes that this proposal “better aligns with statutory requirements under [the ACA], which directs that the scope of EHB be equal to the scope of benefits provided under a typical employer plan.” Public comments must be submitted by March 13, 2026. 

The fact sheet is available here. The press release is available here. 

Impact on General Dentistry: The proposed reversal would limit states’ ability to require adult dental coverage as an EHB and may reduce access to comprehensive dental care for adults in certain insurance markets. AGD will continue to monitor CMS rulemaking.