Bill > HR7164

This bill, titled the "Capping Costs for Consumers Act of 2026," aims to expand financial assistance for individuals purchasing health insurance through an Exchange, which is a marketplace established by the Affordable Care Act (ACA) where individuals can compare and enroll in health plans. Specifically, the bill proposes to shift the basis for cost-sharing reductions, which are discounts on out-of-pocket healthcare expenses like deductibles and copayments, from the "silver" level of coverage to the "gold" level of coverage for plan years beginning on or after January 1, 2028. This means that for individuals with incomes between 150% and 400% of the poverty line, the government will cover a larger portion of their healthcare costs, effectively lowering their out-of-pocket expenses. The bill also makes conforming amendments to state basic health programs and adjusts premium tax credits to align with this shift to gold-level plans, with these changes taking effect for taxable years beginning after December 31, 2027. Additionally, the bill appropriates necessary funds for these expanded cost-sharing reductions.

Business and Industry

https://www.congress.gov/bill/119th-congress/house-bill/7164/all-info