Affordable Health Coverage for Low-Income Individuals in Non-Medicaid Expansion States
This bill aims to ensure more affordable health insurance for low-income individuals in states that have not expanded Medicaid. Individuals with the lowest incomes (up to 138% of the poverty line) will receive significantly higher premium subsidies and almost complete elimination of out-of-pocket costs (cost-sharing) for plan years 2026-2028. Furthermore, the act temporarily expands premium tax credits and introduces special continuous enrollment periods for this population.
Key points
Major Reduction in Healthcare Costs: Individuals with incomes up to 138% of the poverty line (in non-expansion states) will see their cost-sharing reduced to 1% of total allowed costs for 2026-2028.
Additional Benefits: For plan years 2026 and 2027, Silver-level plans must offer extra benefits, such as non-emergency medical transportation services, without imposing cost-sharing.
Easier Enrollment: Introduction of a continuous special enrollment period for low-income individuals, allowing them to sign up for coverage at any time.
Temporary Tax Credit Expansion: For 2026-2028, individuals below 138% of the poverty line can receive premium tax credits even if they are offered employer-sponsored coverage.
Increased Federal Funding for Medicaid: Federal matching funds (FMAP) for newly eligible mandatory individuals in Medicaid expansion states will increase to 93% for 2026-2028.
Status:
Introduced
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