Bridge to Medicaid Act of 2025

This bill helps low‑income adults get affordable health coverage, especially in states that haven’t expanded Medicaid. It strengthens Marketplace discounts and enrollment options to close coverage gaps. For 2026–2028, people with incomes up to about 138% of the federal poverty line will see very low out‑of‑pocket costs—plans must cover about 99% of their costs—and they can sign up any time if they aren’t eligible for other minimum coverage . In 2026–2027, plans must also cover non‑emergency medical transportation and certain additional Medicaid services at no cost to these enrollees .

Premium help is expanded in 2026–2028: people below 100% of poverty can qualify, and some workers offered employer coverage or small‑employer HRAs can still get help paying for Marketplace plans. It also limits how much very low‑income families may have to repay at tax time, and in some cases lets them skip filing a return just to reconcile advance payments . Employers won’t face a penalty when these very low‑income workers receive this help during those years. The federal share of Medicaid costs for the expansion group rises to 93% in 2026–2028, then returns to 90% in 2029 and after. The bill also funds outreach and in‑person help in non‑expansion states to connect people to coverage, including $105 million for outreach and required funding for navigator grants, plus $65 million to implement these changes .

Key points

• Who is affected: Adults with incomes up to about 138% of the federal poverty line, especially in states that haven’t expanded Medicaid; some workers who are offered employer plans but have very low incomes .
• What changes:
  • Much lower copays and deductibles so plans cover about 99% of costs (2026–2028).
  • Year‑round Marketplace enrollment for these adults in 2026–2028 if they lack other minimum coverage.
  • Extra services like non‑emergency medical transportation in 2026–2027, with no out‑of‑pocket costs.
  • Expanded premium discounts in 2026–2028, including for some offered employer coverage or HRAs; limits on payback at tax time .
  • No employer penalty when these very low‑income workers get this help (2026–2028).
  • Higher federal funding for the Medicaid expansion group: 93% in 2026–2028; 90% from 2029 on.
  • Outreach and navigator funding targeted to non‑expansion states; additional funds to carry out the bill .
• When: Most major changes run 2026–2028; added services run 2026–2027; the Medicaid match returns to 90% in 2029 and beyond .