Sponsors (9)
The bill expands and stabilizes marketplace subsidies, enrollment windows, and consumer assistance—improving affordability and access for low‑ and moderate‑income Americans—while increasing federal costs and imposing tighter reporting/penalty rules and administrative burdens that could raise premiums, strain navigators and Exchanges, and create program integrity risks.
Low- and moderate-income people (including many uninsured) will face lower monthly premiums and out-of-pocket costs because expanded premium tax credits are preserved through 2028 and repayment limits for many enrollees are reduced.
People have more time and assistance to sign up for coverage: 2026 open enrollment is extended (through May 1, 2026) and the bill provides $100M in navigator funding and increased outreach/assistance.
Individuals denied advance premium tax credits or who experience verification issues can regain access to subsidized coverage via Special Enrollment Periods, and Exchanges can reenroll people from bronze to silver to access cost‑sharing reductions, improving affordability.
Extending premium tax credits, adding monthly SEPs for some low‑income people, lowering repayment caps, and providing new navigator funding will increase federal outlays and budgetary pressure.
Large, rapid insurer penalties ($1,000 per enrollee per day) and tight notice/reporting deadlines create substantial financial exposure for carriers that could be passed to consumers via higher premiums or lead insurers to narrow offerings or exit markets.
The combination of extended open enrollment, monthly SEPs, strict reporting windows, and new reenrollment rules increases administrative burden and costs for state Exchanges, issuers, and marketplaces, raising the risk of errors or delayed consumer communications.
Based on analysis of 8 sections of legislative text.
Extends enhanced premium tax credits, expands enrollment windows and SEPs, funds navigators, requires issuer notices/reports with penalties, and caps repayment increases for many taxpayers.
Introduced December 4, 2025 by Lisa Blunt Rochester · Last progress December 4, 2025
Extends and expands rules that govern premium tax credits, open enrollment, and Marketplace outreach to stabilize individual health insurance markets. It prolongs temporary enhanced premium tax credits through January 1, 2029, extends the 2026 open enrollment period to May 1, 2026, restores and directs $100 million in navigator funding for Federal Exchanges, creates new special enrollment periods for low-income people and certain verification cases, and caps repayment increases for lower- and middle-income taxpayers. The bill also requires broad issuer notices and reporting to HHS, imposes civil monetary penalties for noncompliance, and directs regulatory changes to plan actuarial value ranges and reenrollment practices to reduce churn and improve continuity of coverage.