HHS keeps the 35% essential community provider rule for 2027 Marketplace plans
Issue
In the 2027 Marketplace final rule published May 15, 2026, HHS dropped its proposal to cut the essential community provider standard from 35% to 20%. Plans must still contract with at least 35% of available essential community providers, including FQHCs, in each service area.
NACHC had opposed the cut and called the result a win on July 8.
Key points
- HHS did not finalize the cut from 35% to 20%, so plans must still contract with at least 35% of essential community providers, including FQHCs.
- NACHC formally opposed the cut in rulemaking comments and claims the preserved threshold as an advocacy win for health-center network access.
- Enrollment teams should know the rule also bars adult routine dental as an essential health benefit and tightens enforcement when tax-credit recipients fail to reconcile.
Sources for this story
HHS/CMS (2027 NBPP final rule); Essential Hospitals; NACHCPart of
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More in Lobbying & Advocacy
FQHC Talent. (2026, July 8). HHS keeps the 35% essential community provider rule for 2027 Marketplace plans. Source: HHS/CMS (2027 NBPP final rule); Essential Hospitals; NACHC. Retrieved November 11, 2026, from https://www.fqhctalent.com/intel/cms-2027-nbpp-final-rule-ecp-35pct-preserved-2026