- Potential benefitMakes marketplace coverage more affordable for middle-income households previously facing high premium costs.
- Potential benefitExtends premium tax credit eligibility to households above 400% of the poverty line.
- Potential benefitLikely increases marketplace enrollment and reduces the number of uninsured individuals.
Health Care Affordability Act of 2025
Read twice and referred to the Committee on Finance.
The bill amends Internal Revenue Code section 36B to change the premium-contribution (applicable) percentages used to calculate the refundable premium tax credit for Marketplace coverage. It creates a new sliding scale of taxpayer contribution percentages across income tiers (0% up to 150% FPL; 0–2% for 150–200% FPL; 2–4% for 200–250% FPL; 4–6% for 250–300% FPL; 6–8.5% for 300–400% FPL; a flat 8.5% for 400%+ FPL).
Liberal emphasizes expanded affordability and equity benefits
Relative to its intended legislative type, this bill is a straightforward substantive amendment to the Internal Revenue Code that specifies numeric changes to the applicable percentage table for the premium tax credit and lists conforming deletions; it sets an explicit effective date.
The bill amends Internal Revenue Code section 36B to change the premium-contribution (applicable) percentages used to calculate the refundable premium tax credit for Marketplace coverage.
It creates a new sliding scale of taxpayer contribution percentages across income tiers (0% up to 150% FPL; 0–2% for 150–200% FPL; 2–4% for 200–250% FPL; 4–6% for 250–300% FPL; 6–8.5% for 300–400% FPL; a flat 8.5% for 400%+ FPL).
The bill removes several existing affordability-related subparagraphs in section 36B(c) and takes effect for taxable years beginning after December 31, 2025.
Clear, administrable change that helps many, but substantial fiscal impact and lack of offsets reduce prospects absent a legislative vehicle or compromise.
Relative to its intended legislative type, this bill is a straightforward substantive amendment to the Internal Revenue Code that specifies numeric changes to the applicable percentage table for the premium tax credit and lists conforming deletions; it sets an explicit effective date. The bill is clear in purpose and specifies the principal legal mechanism, but contains drafting deficiencies and omits fiscal, implementation, oversight, and edge-case detail.
Liberal emphasizes expanded affordability and equity benefits
Who stands to gain, and who may push back.
These are examples from the analysis, not a ranked list of the most-affected groups.
- Federal agenciesIncreases federal spending and likely raises budget deficits absent offsetting revenue or cuts.
- Potential burdenProvides subsidies to higher-income households above 400% FPL who were previously ineligible.
- EmployersCould reduce incentives for some employers to offer comprehensive employer-sponsored coverage.
Why the argument around this bill splits.
Liberal emphasizes expanded affordability and equity benefits
This persona will view the bill positively as expanding financial help for people buying Marketplace coverage and lowering premium burden for lower- and middle-income households.
They will see the extension of subsidy rules beyond 400% FPL and the 0% contribution for the lowest tier as improvements to affordability and equity.
This persona will generally favor the bill's goal of reducing out-of-pocket premiums while seeking caution on fiscal and market effects.
They will support affordability improvements if accompanied by fiscal transparency and evidence that the change won't destabilize insurance markets.
This persona will likely oppose the bill as an unnecessary expansion of federal subsidy and spending that risks market distortion.
They will be especially concerned about extending credits above 400% FPL and removing affordability-related provisions.
The path through Congress.
Reached or meaningfully advanced
Reached or meaningfully advanced
Still ahead
Still ahead
Still ahead
Clear, administrable change that helps many, but substantial fiscal impact and lack of offsets reduce prospects absent a legislative vehicle or compromise.
- Magnitude of fiscal cost and CBO scoring
- Interaction with any existing temporary subsidy law provisions
Recent votes on the bill.
No vote history yet
The bill has not accumulated any surfaced votes yet.
Go deeper than the headline read.
Liberal emphasizes expanded affordability and equity benefits
Clear, administrable change that helps many, but substantial fiscal impact and lack of offsets reduce prospects absent a legislative vehicl…
Relative to its intended legislative type, this bill is a straightforward substantive amendment to the Internal Revenue Code that specifies numeric changes to the applicable percentage table for the premium tax credit a…
Go beyond the headline summary with full stakeholder mapping, legislative design analysis, passage barriers, and lens-by-lens tradeoff breakdowns.