H.R. 6575

[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 6575 Introduced in House (IH)]

<DOC>

119th CONGRESS
1st Session
H. R. 6575

To amend the Internal Revenue Code of 1986 to extend and modify the 
enhanced premium tax credit, to amend the Patient Protection and 
Affordable Care Act to make certain adjustments to the operation of the 
Exchanges established under such Act, and for other purposes.

_______________________________________________________________________

IN THE HOUSE OF REPRESENTATIVES

December 10, 2025

Mrs. Kiggans of Virginia (for herself, Mr. Gottheimer, Mr. Lawler, Mr. 
Cuellar, Mr. Bresnahan, Mr. Suozzi, Mr. Mackenzie, Ms. Lee of Nevada, 
Ms. Salazar, Mr. Landsman, Mr. Van Drew, Mr. Case, Mr. Ciscomani, Mr. 
Costa, Mr. Valadao, Mr. Riley of New York, Mr. Hurd of Colorado, Ms. 
Scholten, Mr. Bacon, Ms. Wilson of Florida, Mr. Gimenez, Ms. 
Goodlander, Ms. De La Cruz, Mr. Soto, Mr. LaLota, Mr. Gray, Mr. Kiley 
of California, Mr. Vicente Gonzalez of Texas, Mr. Kean, Mr. Figures, 
Mr. Fitzpatrick, Mr. Pappas, Mr. Liccardo, Mr. Davis of North Carolina, 
Mr. Moskowitz, Mr. Panetta, Mr. Peters, and Mr. Golden of Maine) 
introduced the following bill; which was referred to the Committee on 
Energy and Commerce, and in addition to the Committees on Ways and 
Means, and Rules, 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

_______________________________________________________________________

A BILL

To amend the Internal Revenue Code of 1986 to extend and modify the 
enhanced premium tax credit, to amend the Patient Protection and 
Affordable Care Act to make certain adjustments to the operation of the 
Exchanges established under such Act, and for other purposes.

Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

This Act may be cited as the ``CommonGround for Affordable Health 
Care Act''.

SEC. 2. EXTENSION AND MODIFICATION OF ENHANCED PREMIUM TAX CREDIT.

(a) Extension and Modification of Rules to Increase Premium 
Assistance Amounts.--Section 36B(b)(3)(A)(iii) of the Internal Revenue 
Code of 1986 is amended--
(1) by redesignating subclauses (I) and (II) as items (aa) 
and (bb), respectively, and adjusting the margins accordingly,
(2) by striking ``Temporary percentages for 2021 through 
2025.--In the case of'' and inserting ``Temporary percentages 
for certain years.--
``(I) Before 2026.--In the case 
of'', and
(3) by adding at the end the following:
``(II) 2026.--In the case of a 
taxable year beginning after December 
31, 2025, and before January 1, 2027--
``(aa) clause (ii) shall 
not apply for purposes of 
adjusting premium percentages 
under this subparagraph, and
``(bb) the following table 
shall be applied in lieu of the 
table contained in clause (i):

----------------------------------------------------------------------------------------------------------------
The initial The final
``In the case of household income (expressed as a percent of poverty line) within the premium premium
following income tier: percentage percentage
is- is-
----------------------------------------------------------------------------------------------------------------
Up to 150% 0.0% 0.0%
150% up to 200% 0.0% 2.0%
200% up to 250% 2.0% 4.0%
250% up to 300% 4.0% 6.0%
300% up to 400% 6.0% 8.5%
400% up to 600% 8.5% 8.5%
600% up to 900% 8.5% 9.25%
900% up to 1000% 9.25% 10.0%''.
----------------------------------------------------------------------------------------------------------------

(b) Extension and Modification of Rule to Allow Credit to Taxpayers 
Whose Household Income Exceeds 400 Percent of Poverty Line.--Section 
36B(c)(1)(E) of such Code is amended--
(1) by striking ``Temporary rule for 2021 through 2025.--In 
the case of'' and inserting ``Temporary rule for certain 
years.--
``(i) Before 2026.--In the case of'', and
(2) by adding at the end the following:
``(ii) 2026.--In the case of a taxable year 
beginning after December 31, 2025, and before 
January 1, 2027, subparagraph (A) shall be 
applied by substituting `but does not exceed 
1000 percent' for `but does not exceed 400 
percent'.''.
(c) Effective Date.--The amendments made by this section shall 
apply to taxable years beginning after December 31, 2025.

SEC. 3. GUARDRAILS TO PREVENT FRAUD IN EXCHANGES.

(a) Reduction of Fraudulent Enrollment in Qualified Health Plans.--
(1) Penalties for agents and brokers.--Section 1411(h)(1) 
of the Patient Protection and Affordable Care Act (42 U.S.C. 
18081(h)(1)) is amended--
(A) in subparagraph (A)--
(i) by redesignating clause (ii) as clause 
(iv);
(ii) in clause (i)--
(I) in the matter preceding 
subclause (I), by striking ``If--'' and 
all that follows through the ``such 
person'' in the matter following 
subclause (II) and inserting the 
following: ``If any person (other than 
an agent or broker) fails to provide 
correct information under subsection 
(b) and such failure is attributable to 
negligence or disregard of any rules or 
regulations of the Secretary, such 
person''; and
(II) in the second sentence, by 
striking ``For purposes'' and inserting 
the following:
``(iii) Definitions of negligence, 
disregard.--For purposes'';
(iii) by inserting after clause (i) the 
following:
``(ii) Civil penalties for certain 
violations by agents or brokers.--If any agent 
or broker fails to provide correct information 
under subsection (b) or section 1311(c)(8) or 
other information, as specified by the 
Secretary, and such failure is attributable to 
negligence or disregard of any rules or 
regulations of the Secretary, such agent or 
broker shall be subject, in addition to any 
other penalties that may be prescribed by law, 
including subparagraph (C), to a civil penalty 
of not less than $10,000 and not more than 
$50,000 with respect to each individual who is 
the subject of an application for which such 
incorrect information is provided.''; and
(iv) in clause (iv) (as so redesignated), 
by inserting ``or (ii)'' after ``clause (i)'';
(B) in subparagraph (B)--
(i) by inserting ``including subparagraph 
(C),'' after ``law,'';
(ii) by striking ``Any person'' and 
inserting the following:
``(i) In general.--Any person''; and
(iii) by adding at the end the following:
``(ii) Civil penalties for knowing 
violations by agents or brokers.--
``(I) In general.--Any agent or 
broker who knowingly provides false or 
fraudulent information under subsection 
(b) or section 1311(c)(8), or other 
false or fraudulent information as part 
of an application for enrollment in a 
qualified health plan offered through 
an Exchange, as specified by the 
Secretary, shall be subject, in 
addition to any other penalties that 
may be prescribed by law, including 
subparagraph (C), to a civil penalty of 
not more than $200,000 with respect to 
each individual who is the subject of 
an application for which such false or 
fraudulent information is provided.
``(II) Procedure.--The provisions 
of section 1128A of the Social Security 
Act (other than subsections (a) and (b) 
of such section) shall apply to a civil 
monetary penalty under subclause (I) in 
the same manner as such provisions 
apply to a penalty or proceeding under 
section 1128A of the Social Security 
Act.''; and
(C) by adding at the end the following:
``(C) Criminal penalties.--Any agent or broker who 
knowingly and willfully provides false or fraudulent 
information under subsection (b) or section 1311(c)(8), 
or other false or fraudulent information as part of an 
application for enrollment in a qualified health plan 
offered through an Exchange, as specified by the 
Secretary, shall be fined under title 18, United States 
Code, imprisoned for not more than 10 years, or 
both.''.
(2) Consumer protections.--
(A) In general.--Section 1311(c) of the Patient 
Protection and Affordable Care Act (42 U.S.C. 18031(c)) 
is amended by adding at the end the following new 
paragraph:
``(8) Agent- or broker-assisted enrollment in qualified 
health plans in certain exchanges.--
``(A) In general.--For plan years beginning on or 
after such date specified by the Secretary, but not 
later than January 1, 2029, in the case of an Exchange 
that the Secretary operates pursuant to section 
1321(c)(1), the Secretary shall establish a 
verification process for new enrollments of individuals 
in, and changes in coverage for individuals under, a 
qualified health plan offered through such Exchange, 
which are submitted by an agent or broker in accordance 
with section 1312(e) and for which the agent or broker 
is eligible to receive a commission.
``(B) Requirements.--The enrollment verification 
process under subparagraph (A) shall include--
``(i) a requirement that the agent or 
broker provide with the new enrollment or 
coverage change such documentation or evidence 
(such as a standardized consent form) or other 
sources as the Secretary determines necessary 
to establish that the agent or broker has the 
consent of the individual for the new 
enrollment or coverage change;
``(ii) a requirement that any commissions 
due to a broker or agent for such new 
enrollment or coverage change are paid after 
the enrollee has resolved all inconsistencies 
in accordance with paragraphs (3) and (4) of 
section 1411(e);
``(iii) a requirement that the information 
required under clause (i) and, as applicable, 
the date on which inconsistencies are resolved 
as described in clause (ii), is accessible to 
the applicable qualified health plan through a 
database or other resource, as determined by 
the Secretary, so that any commissions due to a 
broker or agent for such enrollment can be 
effectuated at the appropriate time;
``(iv) a requirement that individuals are 
notified of any changes to enrollment, 
coverage, the agent of record, or premium tax 
credits in a timely manner and that such notice 
provides plain language instructions on how 
individuals can cancel unauthorized activity;
``(v) a requirement that individuals be 
able to access their account information on a 
website or other technology platform, as 
defined by the Secretary, when used to submit 
an enrollment or plan change, in lieu of the 
Exchange website described in subsection 
(d)(4)(C), including information on the agent 
of record, the qualified health plan, and when 
any changes are made to the agent of record or 
the qualified health plan, on a consumer-facing 
website or through a toll-free telephone 
hotline; and
``(vi) a requirement that the agent or 
broker report to the Secretary any third-party 
marketing organization or field marketing 
organization (as such terms are defined in 
section 1312(e)) involved in the chain of 
enrollment (as so defined) with respect to such 
new enrollment or coverage change.
``(C) Consumer protection.--The Secretary shall 
ensure that the enrollment verification process under 
subparagraph (A) prioritizes continuity of coverage and 
care for individuals, including by not disenrolling 
individuals from a qualified health plan without the 
consent of the individual, regardless of whether the 
broker, agent, or qualified health plan is in violation 
of any requirement under this paragraph.''.
(B) Required reporting.--Section 1311(c)(1) of the 
Patient Protection and Affordable Care Act (42 U.S.C. 
18031(c)(1)) is amended--
(i) in subparagraph (H), by striking 
``and'' at the end;
(ii) in subparagraph (I), by striking the 
period at the end and inserting ``; and''; and
(iii) by adding at the end the following:
``(J) report to the Secretary the termination (as 
defined in section 1312(e)(1)(C)) of an issuer.''.
(3) Authority to regulate field marketing organizations and 
third-party marketing organizations.--Section 1312(e) of the 
Patient Protection and Affordable Care Act (42 U.S.C. 18032(e)) 
is amended--
(A) by redesignating paragraphs (1) and (2) as 
subclauses (I) and (II), respectively, and adjusting 
the margins accordingly;
(B) in subclause (II) (as so redesignated), by 
striking the period at the end and inserting ``; and'';
(C) by striking the subsection designation and 
heading and all that follows through ``brokers--'' and 
inserting the following:
``(e) Regulation of Agents, Brokers, and Certain Marketing 
Organizations.--
``(1) Agents, brokers, and certain marketing 
organizations.--
``(A) In general.--The Secretary shall establish 
procedures under which a State may allow--
``(i) agents or brokers--''; and
(D) by adding at the end the following:
``(ii) field marketing organizations and 
third-party marketing organizations to 
participate in the chain of enrollment for an 
individual with respect to qualified health 
plans offered through an Exchange.
``(B) Criteria.--For plan years beginning on or 
after such date specified by the Secretary, but not 
later than January 1, 2029, the Secretary, by 
regulation, shall establish criteria for States to use 
in determining whether to allow agents and brokers to 
enroll individuals and employers in qualified health 
plans as described in subclause (I) of subparagraph 
(A)(i) and to assist individuals as described in 
subclause (II) of such subparagraph and field marketing 
organizations and third-party marketing organizations 
to participate in the chain of enrollment as described 
in subparagraph (A)(ii). Such criteria shall, at a 
minimum, require that--
``(i) an agent or broker act in accordance 
with a standard of conduct that includes a duty 
of such agent or broker to act in the best 
interests of the enrollee;
``(ii) a field marketing organization or 
third-party marketing organization agree to 
report the termination of an agent or broker to 
the applicable State and the Secretary, 
including the reason for termination; and
``(iii) an agent, broker, field marketing 
organization, or third-party marketing 
organization--
``(I) meet such marketing 
requirements as are required by the 
Secretary;
``(II) meet marketing requirements 
in accordance with other applicable 
Federal or State law;
``(III) does not employ practices 
that are confusing or misleading, as 
determined by the Secretary;
``(IV) submit all marketing 
materials to the Secretary for, as 
determined appropriate by the 
Secretary, review and approval;
``(V) is a licensed agent or broker 
or meets other licensure requirements, 
as required by the State;
``(VI) register with the Secretary; 
and
``(VII) does not compensate any 
individual or organization for 
referrals or any other service relating 
to the sale of, marketing for, or 
enrollment in qualified health plans 
unless such individual or organization 
meets the criteria described in 
subclauses (I) through (VI).
``(C) Definitions.--In this paragraph:
``(i) Chain of enrollment.--The term `chain 
of enrollment', with respect to enrollment of 
an individual in a qualified health plan 
offered through an Exchange, means any steps 
taken from marketing to such individual, to 
such individual making an enrollment decision 
with respect to such a plan.
``(ii) Field marketing organization.--The 
term `field marketing organization' means an 
organization or individual that directly 
employs or contracts with agents and brokers, 
or contracts with carriers, to provide 
functions relating to enrollment of individuals 
in qualified health plans offered through an 
Exchange as part of the chain of enrollment.
``(iii) Marketing.--The term `marketing' 
means the use of marketing materials to provide 
information to current and prospective 
enrollees in a qualified health plan offered 
through an Exchange.
``(iv) Marketing materials.--The term 
`marketing materials' means materials relating 
to a qualified health plan offered through an 
Exchange or benefits offered through an 
Exchange that--
``(I) are intended--
``(aa) to draw an 
individual's attention to such 
plan or the premium tax credits 
or cost-sharing reductions for 
such plan or plans offered 
through an Exchange;
``(bb) to influence an 
individual's decision-making 
process when selecting a 
qualified health plan in which 
to enroll; or
``(cc) to influence an 
enrollee's decision to stay 
enrolled in such plan; and
``(II) include or address content 
regarding the benefits, benefit 
structure, premiums, or cost sharing of 
such plan.
``(v) Termination.--The term `termination', 
with respect to a contract or business 
arrangement between an agent or broker and a 
field marketing organization, third-party 
marketing organization, or health insurance 
issuer, means--
``(I) the ending of such contract 
or business arrangement, either 
unilaterally by one of the parties or 
on mutual agreement; or
``(II) the expiration of such 
contract or business arrangement that 
is not replaced by a substantially 
similar agreement.
``(vi) Third-party marketing 
organization.--The term `third-party marketing 
organization' means an organization or 
individual that is compensated to perform lead 
generation, marketing, or sales relating to 
enrollment of individuals in qualified health 
plans offered through an Exchange as part of 
the chain of enrollment.''.
(4) Transparency.--Section 1312(e) of the Patient 
Protection and Affordable Care Act (42 U.S.C. 18032(e)), as 
amended by paragraph (3), is further amended by adding at the 
end the following new paragraphs:
``(2) Audits.--
``(A) In general.--For plan years beginning on or 
after such date specified by the Secretary, but not 
later than January 1, 2029, the Secretary, in 
coordination with the States and in consultation with 
the National Association of Insurance Commissioners, 
shall implement a process for the oversight and 
enforcement of agent and broker compliance with this 
section and other applicable Federal and State law 
(including regulations) that shall include--
``(i) periodic audits of agents and brokers 
based on--
``(I) complaints filed with the 
Secretary by individuals enrolled by 
such an agent or broker in a qualified 
health plan offered through an 
Exchange;
``(II) an incident or enrollment 
pattern that suggests fraud; and
``(III) other factors determined by 
the Secretary; and
``(ii) a process under which the Secretary 
shall share audit results and refer potential 
cases of fraud to the relevant State department 
of insurance.
``(B) Effect.--Nothing in this paragraph limits or 
restricts any referrals made under section 1311(i)(3) 
or any enforcement actions under section 1411(h).
``(3) List.--The Secretary shall develop a process to 
regularly provide to qualified health plans, Exchanges, and 
States a list of suspended and terminated agents and 
brokers.''.
(b) Removal of Deceased Individuals From Exchange Plans.--Section 
1311(c) of the Patient Protection and Affordable Care Act (42 U.S.C. 
18031(c)), as amended by subsection (a), is further amended by adding 
at the end the following new paragraph:
``(9) Removal of deceased individuals from exchange 
plans.--
``(A) In general.--Not later than 90 days after the 
date of the enactment of this paragraph, and on a 
quarterly basis thereafter, the Secretary shall conduct 
a check of the Death Master File (as such term is 
defined in section 203(d) of the Bipartisan Budget Act 
of 2013) for purposes of identifying individuals 
enrolled in a qualified health plan through an Exchange 
who are deceased.
``(B) Process.--The Secretary shall--
``(i) establish a process to verify that an 
individual identified pursuant to a check 
described in subparagraph (A) is deceased; and
``(ii) require an Exchange to terminate 
such individual's enrollment under a qualified 
health plan.''.
(c) Standard of Proof for Terminating Agents and Brokers.--Section 
1312(e) of the Patient Protection and Affordable Care Act (42 U.S.C. 
18032(e)), as amended by subsection (a), is further amended by adding 
at the end the following new paragraph:
``(4) Standard for termination for certain exchanges.--In 
the case of an agent or broker with an agreement in effect with 
an Exchange operated by the Secretary pursuant to section 
1321(c) to perform activities described in paragraph (1)(A)(i) 
with respect to such Exchange, the Secretary may terminate such 
agreement if the Secretary finds, based on a preponderance of 
the evidence, that such agent or broker has violated such 
agreement, otherwise applicable law, or any other requirement 
applicable to such agent or broker.''.
(d) Requirement for Exchange to Notify Individuals of Value of 
Premium Tax Credits.--Section 1412(c)(2) of the Patient Protection and 
Affordable Care Act (42 U.S.C. 18082(c)(2)) is amended by adding at the 
end the following new subparagraph:
``(C) Exchange responsibilities.--Beginning January 
1, 2027, if an Exchange is notified under paragraph (1) 
of an advance determination under section 1411 with 
respect to the eligibility of an individual for a 
premium tax credit under section 36B of the Internal 
Revenue Code of 1986, the Exchange shall, prior to 
enrolling such individual in a qualified health plan, 
clearly notify such individual of the amount of such 
tax credit.''.

SEC. 4. EXTENDING ANNUAL OPEN ENROLLMENT PERIOD FOR EXCHANGES FOR PLAN 
YEAR 2026.

(a) In General.--The Secretary of Health and Human Services shall 
revise section 155.410(e) of title 45, Code of Federal Regulations (or 
any successor regulation) to provide that the annual open enrollment 
period determined for plan year 2026 pursuant to section 1311(c)(6) of 
the Patient Protection and Affordable Care Act (42 U.S.C. 18031(c)(6)) 
shall begin on November 1, 2025, and end on March 19, 2026.
(b) Notification of Open Enrollment Extension.--The Secretary of 
Health and Human Services shall perform such outreach activities as are 
necessary to inform qualified individuals (as defined in section 
1312(f)(1) of the Patient Protection and Affordable Care Act (42 U.S.C. 
18032(f)(1))) of the extended open enrollment period provided for under 
subsection (a).

SEC. 5. MODERNIZING AND ENSURING PBM ACCOUNTABILITY.

(a) In General.--
(1) Prescription drug plans.--Section 1860D-12 of the 
Social Security Act (42 U.S.C. 1395w-112) is amended by adding 
at the end the following new subsection:
``(h) Requirements Relating to Pharmacy Benefit Managers.--For plan 
years beginning on or after January 1, 2029:
``(1) Agreements with pharmacy benefit managers.--Each 
contract entered into with a PDP sponsor under this part with 
respect to a prescription drug plan offered by such sponsor 
shall provide that any pharmacy benefit manager acting on 
behalf of such sponsor has a written agreement with the PDP 
sponsor under which the pharmacy benefit manager, and any 
affiliates of such pharmacy benefit manager, as applicable, 
agree to meet the following requirements:
``(A) No income other than bona fide service 
fees.--
``(i) In general.--The pharmacy benefit 
manager and any affiliate of such pharmacy 
benefit manager shall not derive any 
remuneration with respect to any services 
provided on behalf of any entity or individual, 
in connection with the utilization of covered 
part D drugs, from any such entity or 
individual other than bona fide service fees, 
subject to clauses (ii) and (iii).
``(ii) Incentive payments.--For the 
purposes of this subsection, an incentive 
payment (as determined by the Secretary) paid 
by a PDP sponsor to a pharmacy benefit manager 
that is performing services on behalf of such 
sponsor shall be deemed a `bona fide service 
fee' (even if such payment does not otherwise 
meet the definition of such term under 
paragraph (7)(B)) if such payment is a flat 
dollar amount, is consistent with fair market 
value (as specified by the Secretary), is 
related to services actually performed by the 
pharmacy benefit manager or affiliate of such 
pharmacy benefit manager, on behalf of the PDP 
sponsor making such payment, in connection with 
the utilization of covered part D drugs, and 
meets additional requirements, if any, as 
determined appropriate by the Secretary.
``(iii) Clarification on rebates and 
discounts used to lower costs for covered part 
d drugs.--Rebates, discounts, and other price 
concessions received by a pharmacy benefit 
manager or an affiliate of a pharmacy benefit 
manager from manufacturers, even if such price 
concessions are calculated as a percentage of a 
drug's price, shall not be considered a 
violation of the requirements of clause (i) if 
they are fully passed through to a PDP sponsor 
and are compliant with all regulatory and 
subregulatory requirements related to direct 
and indirect remuneration for manufacturer 
rebates under this part, including in cases 
where a PDP sponsor is acting as a pharmacy 
benefit manager on behalf of a prescription 
drug plan offered by such PDP sponsor.
``(iv) Evaluation of remuneration 
arrangements.--Components of subsets of 
remuneration arrangements (such as fees or 
other forms of compensation paid to or retained 
by the pharmacy benefit manager or affiliate of 
such pharmacy benefit manager), as determined 
appropriate by the Secretary, between pharmacy 
benefit managers or affiliates of such pharmacy 
benefit managers, as applicable, and other 
entities involved in the dispensing or 
utilization of covered part D drugs (including 
PDP sponsors, manufacturers, pharmacies, and 
other entities as determined appropriate by the 
Secretary) shall be subject to review by the 
Secretary, in consultation with the Office of 
the Inspector General of the Department of 
Health and Human Services, as determined 
appropriate by the Secretary. The Secretary, in 
consultation with the Office of the Inspector 
General, shall review whether remuneration 
under such arrangements is consistent with fair 
market value (as specified by the Secretary) 
through reviews and assessments of such 
remuneration, as determined appropriate.
``(v) Disgorgement.--The pharmacy benefit 
manager shall disgorge any remuneration paid to 
such pharmacy benefit manager or an affiliate 
of such pharmacy benefit manager in violation 
of this subparagraph to the PDP sponsor.
``(vi) Additional requirements.--The 
pharmacy benefit manager shall--
``(I) enter into a written 
agreement with any affiliate of such 
pharmacy benefit manager, under which 
the affiliate shall identify and 
disgorge any remuneration described in 
clause (v) to the pharmacy benefit 
manager; and
``(II) attest, subject to any 
requirements determined appropriate by 
the Secretary, that the pharmacy 
benefit manager has entered into a 
written agreement described in 
subclause (I) with any relevant 
affiliate of the pharmacy benefit 
manager.
``(B) Transparency regarding guarantees and cost 
performance evaluations.--The pharmacy benefit manager 
shall--
``(i) define, interpret, and apply, in a 
fully transparent and consistent manner for 
purposes of calculating or otherwise evaluating 
pharmacy benefit manager performance against 
pricing guarantees or similar cost performance 
measurements related to rebates, discounts, 
price concessions, or net costs, terms such 
as--
``(I) `generic drug', in a manner 
consistent with the definition of the 
term under section 423.4 of title 42, 
Code of Federal Regulations, or a 
successor regulation;
``(II) `brand name drug', in a 
manner consistent with the definition 
of the term under section 423.4 of 
title 42, Code of Federal Regulations, 
or a successor regulation;
``(III) `specialty drug';
``(IV) `rebate'; and
``(V) `discount';
``(ii) identify any drugs, claims, or price 
concessions excluded from any pricing guarantee 
or other cost performance measure in a clear 
and consistent manner; and
``(iii) where a pricing guarantee or other 
cost performance measure is based on a pricing 
benchmark other than the wholesale acquisition 
cost (as defined in section 1847A(c)(6)(B)) of 
a drug, calculate and provide a wholesale 
acquisition cost-based equivalent to the 
pricing guarantee or other cost performance 
measure.
``(C) Provision of information.--
``(i) In general.--Not later than July 1 of 
each year, beginning in 2029, the pharmacy 
benefit manager shall submit to the PDP 
sponsor, and to the Secretary, a report, in 
accordance with this subparagraph, and shall 
make such report available to such sponsor at 
no cost to such sponsor in a format specified 
by the Secretary under paragraph (5). Each such 
report shall include, with respect to such PDP 
sponsor and each plan offered by such sponsor, 
the following information with respect to the 
previous plan year:
``(I) A list of all drugs covered 
by the plan that were dispensed 
including, with respect to each such 
drug--
``(aa) the brand name, 
generic or non-proprietary 
name, and National Drug Code;
``(bb) the number of plan 
enrollees for whom the drug was 
dispensed, the total number of 
prescription claims for the 
drug (including original 
prescriptions and refills, 
counted as separate claims), 
and the total number of dosage 
units of the drug dispensed;
``(cc) the number of 
prescription claims described 
in item (bb) by each type of 
dispensing channel through 
which the drug was dispensed, 
including retail, mail order, 
specialty pharmacy, long term 
care pharmacy, home infusion 
pharmacy, or other types of 
pharmacies or providers;
``(dd) the average 
wholesale acquisition cost, 
listed as cost per day's 
supply, cost per dosage unit, 
and cost per typical course of 
treatment (as applicable);
``(ee) the average 
wholesale price for the drug, 
listed as price per day's 
supply, price per dosage unit, 
and price per typical course of 
treatment (as applicable);
``(ff) the total out-of-
pocket spending by plan 
enrollees on such drug after 
application of any benefits 
under the plan, including plan 
enrollee spending through 
copayments, coinsurance, and 
deductibles;
``(gg) total rebates paid 
by the manufacturer on the drug 
as reported under the Detailed 
DIR Report (or any successor 
report) submitted by such 
sponsor to the Centers for 
Medicare & Medicaid Services;
``(hh) all other direct or 
indirect remuneration on the 
drug as reported under the 
Detailed DIR Report (or any 
successor report) submitted by 
such sponsor to the Centers for 
Medicare & Medicaid Services;
``(ii) the average pharmacy 
reimbursement amount paid by 
the plan for the drug in the 
aggregate and disaggregated by 
dispensing channel identified 
in item (cc);
``(jj) the average National 
Average Drug Acquisition Cost 
(NADAC); and
``(kk) total manufacturer-
derived revenue, inclusive of 
bona fide service fees, 
attributable to the drug and 
retained by the pharmacy 
benefit manager and any 
affiliate of such pharmacy 
benefit manager.
``(II) In the case of a pharmacy 
benefit manager that has an affiliate 
that is a retail, mail order, or 
specialty pharmacy, with respect to 
drugs covered by such plan that were 
dispensed, the following information:
``(aa) The percentage of 
total prescriptions that were 
dispensed by pharmacies that 
are an affiliate of the 
pharmacy benefit manager for 
each drug.
``(bb) The interquartile 
range of the total combined 
costs paid by the plan and plan 
enrollees, per dosage unit, per 
course of treatment, per 30-day 
supply, and per 90-day supply 
for each drug dispensed by 
pharmacies that are not an 
affiliate of the pharmacy 
benefit manager and that are 
included in the pharmacy 
network of such plan.
``(cc) The interquartile 
range of the total combined 
costs paid by the plan and plan 
enrollees, per dosage unit, per 
course of treatment, per 30-day 
supply, and per 90-day supply 
for each drug dispensed by 
pharmacies that are an 
affiliate of the pharmacy 
benefit manager and that are 
included in the pharmacy 
network of such plan.
``(dd) The lowest total 
combined cost paid by the plan 
and plan enrollees, per dosage 
unit, per course of treatment, 
per 30-day supply, and per 90-
day supply, for each drug that 
is available from any pharmacy 
included in the pharmacy 
network of such plan.
``(ee) The difference 
between the average acquisition 
cost of the affiliate, such as 
a pharmacy or other entity that 
acquires prescription drugs, 
that initially acquires the 
drug and the amount reported 
under subclause (I)(jj) for 
each drug.
``(ff) A list inclusive of 
the brand name, generic or non-
proprietary name, and National 
Drug Code of covered part D 
drugs subject to an agreement 
with a covered entity under 
section 340B of the Public 
Health Service Act for which 
the pharmacy benefit manager or 
an affiliate of the pharmacy 
benefit manager had a contract 
or other arrangement with such 
a covered entity in the service 
area of such plan.
``(III) Where a drug approved under 
section 505(c) of the Federal Food, 
Drug, and Cosmetic Act (referred to in 
this subclause as the `listed drug') is 
covered by the plan, the following 
information:
``(aa) A list of currently 
marketed generic drugs approved 
under section 505(j) of the 
Federal Food, Drug, and 
Cosmetic Act pursuant to an 
application that references 
such listed drug that are not 
covered by the plan, are 
covered on the same formulary 
tier or a formulary tier 
typically associated with 
higher cost-sharing than the 
listed drug, or are subject to 
utilization management that the 
listed drug is not subject to.
``(bb) The estimated 
average beneficiary cost-
sharing under the plan for a 
30-day supply of the listed 
drug.
``(cc) Where a generic drug 
listed under item (aa) is on a 
formulary tier typically 
associated with higher cost-
sharing than the listed drug, 
the estimated average cost-
sharing that a beneficiary 
would have paid for a 30-day 
supply of each of the generic 
drugs described in item (aa), 
had the plan provided coverage 
for such drugs on the same 
formulary tier as the listed 
drug.
``(dd) A written 
justification for providing 
more favorable coverage of the 
listed drug than the generic 
drugs described in item (aa).
``(ee) The number of 
currently marketed generic 
drugs approved under section 
505(j) of the Federal Food, 
Drug, and Cosmetic Act pursuant 
to an application that 
references such listed drug.
``(IV) Where a reference product 
(as defined in section 351(i) of the 
Public Health Service Act) is covered 
by the plan, the following information:
``(aa) A list of currently 
marketed biosimilar biological 
products licensed under section 
351(k) of the Public Health 
Service Act pursuant to an 
application that refers to such 
reference product that are not 
covered by the plan, are 
covered on the same formulary 
tier or a formulary tier 
typically associated with 
higher cost-sharing than the 
reference product, or are 
subject to utilization 
management that the reference 
product is not subject to.
``(bb) The estimated 
average beneficiary cost-
sharing under the plan for a 
30-day supply of the reference 
product.
``(cc) Where a biosimilar 
biological product listed under 
item (aa) is on a formulary 
tier typically associated with 
higher cost-sharing than the 
reference product, the 
estimated average cost-sharing 
that a beneficiary would have 
paid for a 30-day supply of 
each of the biosimilar 
biological products described 
in item (aa), had the plan 
provided coverage for such 
products on the same formulary 
tier as the reference product.
``(dd) A written 
justification for providing 
more favorable coverage of the 
reference product than the 
biosimilar biological product 
described in item (aa).
``(ee) The number of 
currently marketed biosimilar 
biological products licensed 
under section 351(k) of the 
Public Health Service Act, 
pursuant to an application that 
refers to such reference 
product.
``(V) Total gross spending on 
covered part D drugs by the plan, not 
net of rebates, fees, discounts, or 
other direct or indirect remuneration.
``(VI) The total amount retained by 
the pharmacy benefit manager or an 
affiliate of such pharmacy benefit 
manager in revenue related to 
utilization of covered part D drugs 
under that plan, inclusive of bona fide 
service fees.
``(VII) The total spending on 
covered part D drugs net of rebates, 
fees, discounts, or other direct and 
indirect remuneration by the plan.
``(VIII) An explanation of any 
benefit design parameters under such 
plan that encourage plan enrollees to 
fill prescriptions at pharmacies that 
are an affiliate of such pharmacy 
benefit manager, such as mail and 
specialty home delivery programs, and 
retail and mail auto-refill programs.
``(IX) The following information:
``(aa) A list of all 
brokers, consultants, advisors, 
and auditors that receive 
compensation from the pharmacy 
benefit manager or an affiliate 
of such pharmacy benefit 
manager for referrals, 
consulting, auditing, or other 
services offered to PDP 
sponsors related to pharmacy 
benefit management services.
``(bb) The amount of 
compensation provided by such 
pharmacy benefit manager or 
affiliate to each such broker, 
consultant, advisor, and 
auditor.
``(cc) The methodology for 
calculating the amount of 
compensation provided by such 
pharmacy benefit manager or 
affiliate, for each such 
broker, consultant, advisor, 
and auditor.
``(X) A list of all affiliates of 
the pharmacy benefit manager.
``(XI) A summary document submitted 
in a standardized template developed by 
the Secretary that includes such 
information described in subclauses (I) 
through (X).
``(ii) Written explanation of contracts or 
agreements with drug manufacturers.--
``(I) In general.--The pharmacy 
benefit manager shall, not later than 
30 days after the finalization of any 
contract or agreement between such 
pharmacy benefit manager or an 
affiliate of such pharmacy benefit 
manager and a drug manufacturer (or 
subsidiary, agent, or entity affiliated 
with such drug manufacturer) that makes 
rebates, discounts, payments, or other 
financial incentives related to one or 
more covered part D drugs or other 
prescription drugs, as applicable, of 
the manufacturer directly or indirectly 
contingent upon coverage, formulary 
placement, or utilization management 
conditions on any other covered part D 
drugs or other prescription drugs, as 
applicable, submit to the PDP sponsor a 
written explanation of such contract or 
agreement.
``(II) Requirements.--A written 
explanation under subclause (I) shall--
``(aa) include the 
manufacturer subject to the 
contract or agreement, all 
covered part D drugs and other 
prescription drugs, as 
applicable, subject to the 
contract or agreement and the 
manufacturers of such drugs, 
and a high-level description of 
the terms of such contract or 
agreement and how such terms 
apply to such drugs; and
``(bb) be certified by the 
Chief Executive Officer, Chief 
Financial Officer, or General 
Counsel of such pharmacy 
benefit manager, or affiliate 
of such pharmacy benefit 
manager, as applicable, or an 
individual delegated with the 
authority to sign on behalf of 
one of these officers, who 
reports directly to the 
officer.
``(III) Definition of other 
prescription drugs.--For purposes of 
this clause, the term `other 
prescription drugs' means prescription 
drugs covered as supplemental benefits 
under this part or prescription drugs 
paid outside of this part.
``(D) Audit rights.--
``(i) In general.--Not less than once a 
year, at the request of the PDP sponsor, the 
pharmacy benefit manager shall allow for an 
audit of the pharmacy benefit manager to ensure 
compliance with all terms and conditions under 
the written agreement described in this 
paragraph and the accuracy of information 
reported under subparagraph (C).
``(ii) Auditor.--The PDP sponsor shall have 
the right to select an auditor. The pharmacy 
benefit manager shall not impose any 
limitations on the selection of such auditor.
``(iii) Provision of information.--The 
pharmacy benefit manager shall make available 
to such auditor all records, data, contracts, 
and other information necessary to confirm the 
accuracy of information provided under 
subparagraph (C), subject to reasonable 
restrictions on how such information must be 
reported to prevent redisclosure of such 
information.
``(iv) Timing.--The pharmacy benefit 
manager must provide information under clause 
(iii) and other information, data, and records 
relevant to the audit to such auditor within 6 
months of the initiation of the audit and 
respond to requests for additional information 
from such auditor within 30 days after the 
request for additional information.
``(v) Information from affiliates.--The 
pharmacy benefit manager shall be responsible 
for providing to such auditor information 
required to be reported under subparagraph (C) 
or under clause (iii) of this subparagraph that 
is owned or held by an affiliate of such 
pharmacy benefit manager.
``(2) Enforcement.--
``(A) In general.--Each PDP sponsor shall--
``(i) disgorge to the Secretary any amounts 
disgorged to the PDP sponsor by a pharmacy 
benefit manager under paragraph (1)(A)(v);
``(ii) require, in a written agreement with 
any pharmacy benefit manager acting on behalf 
of such sponsor or affiliate of such pharmacy 
benefit manager, that such pharmacy benefit 
manager or affiliate reimburse the PDP sponsor 
for any civil money penalty imposed on the PDP 
sponsor as a result of the failure of the 
pharmacy benefit manager or affiliate to meet 
the requirements of paragraph (1) that are 
applicable to the pharmacy benefit manager or 
affiliate under the agreement; and
``(iii) require, in a written agreement 
with any such pharmacy benefit manager acting 
on behalf of such sponsor or affiliate of such 
pharmacy benefit manager, that such pharmacy 
benefit manager or affiliate be subject to 
punitive remedies for breach of contract for 
failure to comply with the requirements 
applicable under paragraph (1).
``(B) Reporting of alleged violations.--The 
Secretary shall make available and maintain a mechanism 
for manufacturers, PDP sponsors, pharmacies, and other 
entities that have contractual relationships with 
pharmacy benefit managers or affiliates of such 
pharmacy benefit managers to report, on a confidential 
basis, alleged violations of paragraph (1)(A) or 
subparagraph (C).
``(C) Anti-retaliation and anti-coercion.--
Consistent with applicable Federal or State law, a PDP 
sponsor shall not--
``(i) retaliate against an individual or 
entity for reporting an alleged violation under 
subparagraph (B); or
``(ii) coerce, intimidate, threaten, or 
interfere with the ability of an individual or 
entity to report any such alleged violations.
``(3) Certification of compliance.--
``(A) In general.--Each PDP sponsor shall furnish 
to the Secretary (at a time and in a manner specified 
by the Secretary) an annual certification of compliance 
with this subsection, as well as such information as 
the Secretary determines necessary to carry out this 
subsection.
``(B) Implementation.--Notwithstanding any other 
provision of law, the Secretary may implement this 
paragraph by program instruction or otherwise.
``(4) Rule of construction.--Nothing in this subsection 
shall be construed as--
``(A) prohibiting flat dispensing fees or 
reimbursement or payment for ingredient costs 
(including customary, industry-standard discounts 
directly related to drug acquisition that are retained 
by pharmacies or wholesalers) to entities that acquire 
or dispense prescription drugs; or
``(B) modifying regulatory requirements or sub-
regulatory program instruction or guidance related to 
pharmacy payment, reimbursement, or dispensing fees.
``(5) Standard formats.--
``(A) In general.--Not later than June 1, 2028, the 
Secretary shall specify standard, machine-readable 
formats for pharmacy benefit managers to submit annual 
reports required under paragraph (1)(C)(i).
``(B) Implementation.--Notwithstanding any other 
provision of law, the Secretary may implement this 
paragraph by program instruction or otherwise.
``(6) Confidentiality.--
``(A) In general.--Information disclosed by a 
pharmacy benefit manager, an affiliate of a pharmacy 
benefit manager, a PDP sponsor, or a pharmacy under 
this subsection that is not otherwise publicly 
available or available for purchase shall not be 
disclosed by the Secretary or a PDP sponsor receiving 
the information, except that the Secretary may disclose 
the information for the following purposes:
``(i) As the Secretary determines necessary 
to carry out this part.
``(ii) To permit the Comptroller General to 
review the information provided.
``(iii) To permit the Director of the 
Congressional Budget Office to review the 
information provided.
``(iv) To permit the Executive Director of 
the Medicare Payment Advisory Commission to 
review the information provided.
``(v) To the Attorney General for the 
purposes of conducting oversight and 
enforcement under this title.
``(vi) To the Inspector General of the 
Department of Health and Human Services in 
accordance with its authorities under the 
Inspector General Act of 1978 (section 406 of 
title 5, United States Code), and other 
applicable statutes.
``(B) Restriction on use of information.--The 
Secretary, the Comptroller General, the Director of the 
Congressional Budget Office, and the Executive Director 
of the Medicare Payment Advisory Commission shall not 
report on or disclose information disclosed pursuant to 
subparagraph (A) to the public in a manner that would 
identify--
``(i) a specific pharmacy benefit manager, 
affiliate, pharmacy, manufacturer, wholesaler, 
PDP sponsor, or plan; or
``(ii) contract prices, rebates, discounts, 
or other remuneration for specific drugs in a 
manner that may allow the identification of 
specific contracting parties or of such 
specific drugs.
``(7) Definitions.--For purposes of this subsection:
``(A) Affiliate.--The term `affiliate' means, with 
respect to any pharmacy benefit manager or PDP sponsor, 
any entity that, directly or indirectly--
``(i) owns or is owned by, controls or is 
controlled by, or is otherwise related in any 
ownership structure to such pharmacy benefit 
manager or PDP sponsor; or
``(ii) acts as a contractor, principal, or 
agent to such pharmacy benefit manager or PDP 
sponsor, insofar as such contractor, principal, 
or agent performs any of the functions 
described under subparagraph (C).
``(B) Bona fide service fee.--The term `bona fide 
service fee' means a fee that is reflective of the fair 
market value (as specified by the Secretary, through 
notice and comment rulemaking) for a bona fide, 
itemized service actually performed on behalf of an 
entity, that the entity would otherwise perform (or 
contract for) in the absence of the service arrangement 
and that is not passed on in whole or in part to a 
client or customer, whether or not the entity takes 
title to the drug. Such fee must be a flat dollar 
amount and shall not be directly or indirectly based 
on, or contingent upon--
``(i) drug price, such as wholesale 
acquisition cost or drug benchmark price (such 
as average wholesale price);
``(ii) the amount of discounts, rebates, 
fees, or other direct or indirect remuneration 
with respect to covered part D drugs dispensed 
to enrollees in a prescription drug plan, 
except as permitted pursuant to paragraph 
(1)(A)(ii);
``(iii) coverage or formulary placement 
decisions or the volume or value of any 
referrals or business generated between the 
parties to the arrangement; or
``(iv) any other amounts or methodologies 
prohibited by the Secretary.
``(C) Pharmacy benefit manager.--The term `pharmacy 
benefit manager' means any person or entity that, 
either directly or through an intermediary, acts as a 
price negotiator or group purchaser on behalf of a PDP 
sponsor or prescription drug plan, or manages the 
prescription drug benefits provided by such sponsor or 
plan, including the processing and payment of claims 
for prescription drugs, the performance of drug 
utilization review, the processing of drug prior 
authorization requests, the adjudication of appeals or 
grievances related to the prescription drug benefit, 
contracting with network pharmacies, controlling the 
cost of covered part D drugs, or the provision of 
related services. Such term includes any person or 
entity that carries out one or more of the activities 
described in the preceding sentence, irrespective of 
whether such person or entity calls itself a `pharmacy 
benefit manager'.''.
(2) MA-PD plans.--Section 1857(f)(3) of the Social Security 
Act (42 U.S.C. 1395w-27(f)(3)) is amended by adding at the end 
the following new subparagraph:
``(F) Requirements relating to pharmacy benefit 
managers.--For plan years beginning on or after January 
1, 2029, section 1860D-12(h).''.
(3) Nonapplication of paperwork reduction act.--Chapter 35 
of title 44, United States Code, shall not apply to the 
implementation of this subsection.
(4) Funding.--
(A) Secretary.--In addition to amounts otherwise 
available, there is appropriated to the Centers for 
Medicare & Medicaid Services Program Management 
Account, out of any money in the Treasury not otherwise 
appropriated, $113,000,000 for fiscal year 2026, to 
remain available until expended, to carry out this 
subsection.
(B) OIG.--In addition to amounts otherwise 
available, there is appropriated to the Inspector 
General of the Department of Health and Human Services, 
out of any money in the Treasury not otherwise 
appropriated, $20,000,000 for fiscal year 2026, to 
remain available until expended, to carry out this 
subsection.
(b) GAO Study and Report on Price-Related Compensation Across the 
Supply Chain.--
(1) Study.--The Comptroller General of the United States 
(in this subsection referred to as the ``Comptroller General'') 
shall conduct a study describing the use of compensation and 
payment structures related to a prescription drug's price 
within the retail prescription drug supply chain in part D of 
title XVIII of the Social Security Act (42 U.S.C. 1395w-101 et 
seq.). Such study shall summarize information from Federal 
agencies and industry experts, to the extent available, with 
respect to the following:
(A) The type, magnitude, other features (such as 
the pricing benchmarks used), and prevalence of 
compensation and payment structures related to a 
prescription drug's price, such as calculating fee 
amounts as a percentage of a prescription drug's price, 
between intermediaries in the prescription drug supply 
chain, including--
(i) pharmacy benefit managers;
(ii) PDP sponsors offering prescription 
drug plans and Medicare Advantage organizations 
offering MA-PD plans;
(iii) drug wholesalers;
(iv) pharmacies;
(v) manufacturers;
(vi) pharmacy services administrative 
organizations;
(vii) brokers, auditors, consultants, and 
other entities that--
(I) advise PDP sponsors offering 
prescription drug plans and Medicare 
Advantage organizations offering MA-PD 
plans regarding pharmacy benefits; or
(II) review PDP sponsor and 
Medicare Advantage organization 
contracts with pharmacy benefit 
managers; and
(viii) other service providers that 
contract with any of the entities described in 
clauses (i) through (vii) that may use price-
related compensation and payment structures, 
such as rebate aggregators (or other entities 
that negotiate or process price concessions on 
behalf of pharmacy benefit managers, plan 
sponsors, or pharmacies).
(B) The primary business models and compensation 
structures for each category of intermediary described 
in subparagraph (A).
(C) Variation in price-related compensation 
structures between affiliated entities (such as 
entities with common ownership, either full or partial, 
and subsidiary relationships) and unaffiliated 
entities.
(D) Potential conflicts of interest among 
contracting entities related to the use of prescription 
drug price-related compensation structures, such as the 
potential for fees or other payments set as a 
percentage of a prescription drug's price to advantage 
formulary selection, distribution, or purchasing of 
prescription drugs with higher prices.
(E) Notable differences, if any, in the use and 
level of price-based compensation structures over time 
and between different market segments, such as under 
part D of title XVIII of the Social Security Act (42 
U.S.C. 1395w-101 et seq.) and the Medicaid program 
under title XIX of such Act (42 U.S.C. 1396 et seq.).
(F) The effects of drug price-related compensation 
structures and alternative compensation structures on 
Federal health care programs and program beneficiaries, 
including with respect to cost-sharing, premiums, 
Federal outlays, biosimilar and generic drug adoption 
and utilization, drug shortage risks, and the potential 
for fees set as a percentage of a drug's price to 
advantage the formulary selection, distribution, or 
purchasing of drugs with higher prices.
(G) Other issues determined to be relevant and 
appropriate by the Comptroller General.
(2) Report.--Not later than 2 years after the date of 
enactment of this section, the Comptroller General shall submit 
to Congress a report containing the results of the study 
conducted under paragraph (1), together with recommendations 
for such legislation and administrative action as the 
Comptroller General determines appropriate.
(c) MedPAC Reports on Agreements With Pharmacy Benefit Managers 
With Respect to Prescription Drug Plans and MA-PD Plans.--
(1) In general.--The Medicare Payment Advisory Commission 
shall submit to Congress the following reports:
(A) Initial report.--Not later than the first March 
15 occurring after the date that is 2 years after the 
date on which the Secretary makes the data available to 
the Commission, a report regarding agreements with 
pharmacy benefit managers with respect to prescription 
drug plans and MA-PD plans. Such report shall include, 
to the extent practicable--
(i) a description of trends and patterns, 
including relevant averages, totals, and other 
figures for the types of information submitted;
(ii) an analysis of any differences in 
agreements and their effects on plan enrollee 
out-of-pocket spending and average pharmacy 
reimbursement, and other impacts; and
(iii) any recommendations the Commission 
determines appropriate.
(B) Final report.--Not later than 2 years after the 
date on which the Commission submits the initial report 
under subparagraph (A), a report describing any changes 
with respect to the information described in 
subparagraph (A) over time, together with any 
recommendations the Commission determines appropriate.
(2) Funding.--In addition to amounts otherwise available, 
there is appropriated to the Medicare Payment Advisory 
Commission, out of any money in the Treasury not otherwise 
appropriated, $1,000,000 for fiscal year 2026, to remain 
available until expended, to carry out this subsection.

SEC. 6. EXPEDITED CONSIDERATION OF ENHANCED PREMIUM TAX CREDIT REFORM 
BILL.

(a) Qualifying Legislation.--
(1) In general.--Only an enhanced premium tax credit reform 
bill shall be entitled to expedited consideration under this 
section.
(2) Definition.--In this section, the term ``enhanced 
premium tax credit reform bill'' means a bill or joint 
resolution which consists solely of legislative language with 
respect to continued health insurance premium savings, 
including more significant reforms, that has accumulated at 
least 10 cosponsors from each of the majority party and the 
minority party at the time it is offered.
(b) Consideration in the House of Representatives.--
(1) Referral and reporting.--Any committee of the House of 
Representatives to which an enhanced premium tax credit reform 
bill is referred shall report the enhanced premium tax credit 
reform bill to the House of Representatives without amendment 
not later than 5 legislative days after the date on which the 
enhanced premium tax credit reform bill was so referred. If a 
committee of the House of Representatives fails to report an 
enhanced premium tax credit reform bill within that period, 
that committee shall be automatically discharged from 
consideration of the enhanced premium tax credit reform bill, 
and the enhanced premium tax credit reform bill shall be placed 
on the appropriate calendar.
(2) Proceeding to consideration.--After the last committee 
authorized to consider an enhanced premium tax credit reform 
bill reports it to the House of Representatives or has been 
discharged from its consideration, it shall be in order to move 
to proceed to consider the enhanced premium tax credit reform 
bill in the House of Representatives. Such a motion shall not 
be in order after the House of Representatives has disposed of 
a motion to proceed with respect to the enhanced premium tax 
credit reform bill. The previous question shall be considered 
as ordered on the motion to its adoption without intervening 
motion. The motion shall not be debatable. A motion to 
reconsider the vote by which the motion is disposed of shall 
not be in order.
(3) Vote on passage.--The vote on passage of the enhanced 
premium tax credit reform bill shall occur not later than 3 
legislative days after the date on which the last committee 
authorized to consider the enhanced premium tax credit reform 
bill reports it to the House of Representatives or is 
discharged.
(c) Expedited Procedure in the Senate.--
(1) Committee consideration.--An enhanced premium tax 
credit reform bill introduced in the Senate shall be jointly 
referred to the committee or committees of jurisdiction, which 
committees shall report the enhanced premium tax credit reform 
bill without any revision and with a favorable recommendation, 
an unfavorable recommendation, or without recommendation, not 
later than 5 session days after the date on which the enhanced 
premium tax credit reform bill was so referred. If any 
committee to which an enhanced premium tax credit reform bill 
is referred fails to report the enhanced premium tax credit 
reform bill within that period, that committee shall be 
automatically discharged from consideration of the enhanced 
premium tax credit reform bill, and the enhanced premium tax 
credit reform bill shall be placed on the appropriate calendar.
(2) Proceeding.--Notwithstanding rule XXII of the Standing 
Rules of the Senate, it is in order, not later than 2 days of 
session after the date on which an enhanced premium tax credit 
reform bill is reported or discharged from all committees to 
which the enhanced premium tax credit reform bill was referred, 
for the majority leader of the Senate or the designee of the 
majority leader to move to proceed to the consideration of the 
enhanced premium tax credit reform bill. It shall also be in 
order for any Member of the Senate to move to proceed to the 
consideration of the enhanced premium tax credit reform bill at 
any time after the conclusion of such 2-day period. A motion to 
proceed is in order even though a previous motion to the same 
effect has been disagreed to. All points of order against the 
motion to proceed to the enhanced premium tax credit reform 
bill are waived. The motion to proceed is not debatable. The 
motion is not subject to a motion to postpone. A motion to 
reconsider the vote by which the motion is agreed to or 
disagreed to shall not be in order. If a motion to proceed to 
the consideration of the enhanced premium tax credit reform 
bill is agreed to, the enhanced premium tax credit reform bill 
shall remain the unfinished business until disposed of. All 
points of order against an enhanced premium tax credit reform 
bill and against consideration of the enhanced premium tax 
credit reform bill are waived.
(d) Consideration by the Other House.--
(1) In general.--If, before passing an enhanced premium tax 
credit reform bill, a House receives from the other House an 
enhanced premium tax credit reform bill of the other House--
(A) the enhanced premium tax credit reform bill of 
the other House shall not be referred to a committee; 
and
(B) the procedure in the receiving House shall be 
the same as if no enhanced premium tax credit reform 
bill had been received from the other House until the 
vote on passage, when the enhanced premium tax credit 
reform bill received from the other House shall 
supplant the enhanced premium tax credit reform bill of 
the receiving House.
(2) Revenue measures.--This subsection shall not apply to 
the House of Representatives if an enhanced premium tax credit 
reform bill received from the Senate is a revenue measure.
(e) Rules to Coordinate Action With Other House.--
(1) Treatment of enhanced premium tax credit reform bill of 
other house.--If an enhanced premium tax credit reform bill is 
not introduced in the Senate or the Senate fails to consider an 
enhanced premium tax credit reform bill under this section, the 
enhanced premium tax credit reform bill of the House of 
Representatives shall be entitled to expedited floor procedures 
under this section.
(2) Treatment of companion measures in the senate.--If, 
following passage of an enhanced premium tax credit reform bill 
in the Senate, the Senate then receives from the House of 
Representatives an enhanced premium tax credit reform bill, the 
House-passed enhanced premium tax credit reform bill shall not 
be debatable. The vote on passage of the enhanced premium tax 
credit reform bill in the Senate shall be considered to be the 
vote on passage of the enhanced premium tax credit reform bill 
received from the House of Representatives.
(3) Vetoes.--If the President vetoes an enhanced premium 
tax credit reform bill, consideration of a veto message in the 
Senate under this paragraph shall be 10 hours equally divided 
between the majority and minority leaders of the Senate or the 
designees of the majority and minority leaders of the Senate.
(f) Vote on Passage.--The vote on final passage in the House of 
Representatives and the Senate of the enhanced premium tax credit 
reform bill shall occur not later than July 1, 2026.
(g) Exercise of Rulemaking Power.--This section is enacted by 
Congress--
(1) as an exercise of the rulemaking power of the Senate 
and House of Representatives, respectively, and as such it is 
deemed a part of the rules of each House, respectively, but 
applicable only with respect to the procedure to be followed in 
that House in the case of an enhanced premium tax credit reform 
bill, and it supersedes other rules only to the extent that it 
is inconsistent with such rules; and
(2) with full recognition of the constitutional right of 
either House to change the rules (so far as relating to the 
procedure of that House) at any time, in the same manner, and 
to the same extent as in the case of any other rule of that 
House.
<all>