Protecting Access to Affordable Coverage Act of 2025
- Bill Number
- H.R. 6760
- Origin Chamber
- House
- Congress
- 119th Congress, Session 1
- Policy Area
- Health
- Status
- Introduced
- Latest Action
- 2025-12-16: Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
- Last Updated
- 2026-01-15T13:25:23Z
AI-Generated Summary
Purpose of the Legislation
The Protecting Access to Affordable Coverage Act of 2025 aims to make it easier for individuals to sign up for health insurance plans under the Affordable Care Act (ACA), also known as Obamacare. It focuses on extending enrollment windows, reducing barriers to eligibility for financial help, and improving support programs to help people navigate the system.
Key Provisions
- Extended Open Enrollment for 2026: The standard sign-up period for health plans starting in 2026 will run from November 1, 2025, to at least May 1, 2026, giving people more time to enroll.
- Repeal of Verification Rules: Removes new requirements from a 2025 law (Public Law 119-21) that made it harder to verify income and eligibility for premium tax credits (financial assistance to lower insurance costs). This restores the simpler rules from before that law.
- Easier Access for Low-Income People:
- Removes a restriction in tax law that previously limited premium tax credits for certain lawfully present immigrants (non-citizens living legally in the U.S.).
- Creates a new special enrollment period: Starting in 2026, people eligible for advance premium tax credits with household income at or below 150% of the federal poverty level (about $22,000 for a single person or $45,000 for a family of four in 2025) can sign up once per month.
- Improvements to Navigator Program:
- State-run health insurance marketplaces (exchanges) must award grants to at least one local organization with a physical office in the state, starting in 2026, to help people enroll.
- For 2026 and later, navigator organizations cannot be "enhanced direct enrollment entities" (companies that handle enrollments directly with insurers), cannot charge fees to applicants, and cannot accept payments from or on behalf of enrollees.
- Provides dedicated funding: $100 million per year starting in fiscal year 2026 (October 2025–September 2026) from fees paid by health insurers to the federal government. This money is allocated to federally run exchanges based on the number of people already enrolled in plans or Medicaid in each state, with a base amount of $1.25 million per state plus a share of the rest.
Significant Changes to Existing Law
- To the ACA: Adds a longer open enrollment period specifically for 2026 and a monthly special enrollment option for very low-income people, which does not exist now (current special periods are limited to events like losing other coverage or moving).
- To Tax Law (Internal Revenue Code): Strikes a clause that blocked premium tax credits for some lawfully present immigrants, expanding who can get financial help.
- Reversal of Recent Changes: Undoes 2025 verification rules that required more proof of eligibility, potentially slowing enrollments, by reverting to pre-2025 standards.
- Navigator Rules: Mandates local presence and bans conflicts of interest (like fees or ties to insurers), while securing new, stable funding for federal exchanges—previously, funding was less predictable.
Potential Impacts
- On Citizens: Low-income and uninsured individuals, especially immigrants, may find it simpler and less intimidating to get affordable health coverage, potentially increasing enrollment by millions and reducing medical debt. However, it could raise overall healthcare costs if more people join plans.
- On Government Agencies: The Department of Health and Human Services (HHS) and Internal Revenue Service (IRS) will need to update systems for easier verifications, new enrollment periods, and grant management, possibly requiring more staff or IT changes. Federal funding from insurer fees avoids new taxpayer costs.
- On International Relations: Minimal direct impact, though expanded coverage for lawfully present immigrants could indirectly support U.S. policies on legal migration and humanitarian aid.
Main Stakeholders Affected
- Individuals and Families: Especially low-income households (under 150% of poverty level), uninsured people, and lawfully present immigrants seeking ACA plans.
- Health Insurance Companies: May see more customers but also face higher fees contributing to navigator funding.
- Navigator Organizations: Non-profits and community groups that help with enrollment will get mandatory grants but must meet stricter rules on location and independence.
- State and Federal Governments: State exchanges gain requirements for local grants; federal exchanges (in states without their own) receive allocated funds to support enrollment assistance.
- Taxpayers and Broader Public: Indirectly affected through stabilized ACA operations, potentially leading to healthier populations and lower emergency care costs.
Notable Legal, Constitutional, or Political Implications
- Legal: Strengthens ACA implementation by reducing administrative hurdles, aligning with court rulings upholding the law's core (e.g., premium tax credits). The repeal of verification rules could face challenges if seen as weakening fraud prevention, but it restores prior legal standards.
- Constitutional: No major issues; it expands access under Congress's taxing and spending powers (used for ACA subsidies), without infringing on states' rights—states can still run their own exchanges.
- Political: Represents a bipartisan push (introduced by Democrats) to bolster the ACA amid ongoing debates over healthcare affordability. It could increase political support for the law by addressing access gaps but might draw criticism for adding costs or favoring certain groups, influencing future elections or budget fights.
This summary was generated by AI and may contain inaccuracies. Refer to the official source document for the authoritative text.
Sponsor
Cosponsors (5)
Del. Norton, Eleanor Holmes [D-DC-At Large], Rep. Goodlander, Maggie [D-NH-2], Rep. Johnson, Julie [D-TX-32], Rep. Salinas, Andrea [D-OR-6], Rep. McClain Delaney, April [D-MD-6]
Recent Actions
- 2025-12-16: Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
- 2025-12-16: Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
- 2025-12-16: Introduced in House
- 2025-12-16: Introduced in House
Bill Versions
- Protecting Access to Affordable Coverage Act of 2025 — issued 2025-12-16 — PDF (8 pages)