H.R. 7164: Capping Costs for Consumers Act of 2026
The Capping Costs for Consumers Act of 2026 aims to improve healthcare affordability by enhancing cost-sharing reductions for individuals enrolled in health plans offered through government exchanges. Here are the key components of the bill:
1. Expanding Cost-Sharing Reductions
The bill modifies existing laws regarding cost-sharing reductions, which help lower out-of-pocket costs for consumers who purchase health insurance through exchanges. Some main changes include:- For plan years starting on or after January 1, 2028, eligible insured individuals will receive increased reductions by referencing a "gold" level of coverage instead of a "silver" level.
- Specifically, for different income levels, the bill adjusts the percentage of costs covered by insurance plans. For example:
- For incomes above 200% but not over 250% of the poverty line, coverage will increase from 73% to 85% starting in 2028.
- For individuals earning between 250% and 400% of the poverty line, the coverage will go from 70% to 85% for years starting after 2028.
2. Conforming Amendments
The legislation also makes conforming amendments related to state health programs for low-income individuals, particularly changing references from "silver" plans to "gold" plans in applicable laws, ensuring alignment with the proposed changes to cost-sharing reductions.3. Premium Assistance Changes
It modifies how premium assistance credits are determined by shifting the reference from "silver" plans to "gold" plans. This change will take effect beginning with the tax year after December 31, 2027.4. Funding
The bill allows for necessary funds to be appropriated from the Treasury to support the enhanced payments required under these new provisions.Relevant Companies
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Sponsors
2 bill sponsors
Actions
2 actions
| Date | Action |
|---|---|
| Jan. 20, 2026 | Introduced in House |
| Jan. 20, 2026 | 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. |
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