H.R. 7164

[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 7164 Introduced in House (IH)]

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119th CONGRESS
2d Session
H. R. 7164

To expand cost-sharing reductions with respect to qualified health 
plans offered through an Exchange, and for other purposes.

_______________________________________________________________________

IN THE HOUSE OF REPRESENTATIVES

January 20, 2026

Ms. Schrier (for herself and Ms. Budzinski) introduced the following 
bill; which was 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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A BILL

To expand cost-sharing reductions with respect to qualified health 
plans offered through an Exchange, 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 ``Capping Costs for Consumers Act of 
2026''.

SEC. 2. EXPANDING COST-SHARING REDUCTIONS UNDER EXCHANGE PLANS.

(a) In General.--Section 1402 of the Patient Protection and 
Affordable Care Act (42 U.S.C. 18071) is amended--
(1) in subsection (b)--
(A) in paragraph (1), by striking ``who enrolls'' 
and inserting ``subject to the last sentence of this 
subsection, who enrolls''; and
(B) by adding at the end the following sentence: 
``With respect to plan years beginning on or after 
January 1, 2028, paragraph (1) shall be applied as if 
the reference to the silver level of coverage were a 
reference to the gold level of coverage.'';
(2) in subsection (c)(1)(B)(i)--
(A) in subclause (II), by striking ``an eligible 
insured described in paragraph (2)(B)'' and inserting 
``, with respect to plan years beginning before January 
1, 2028, an eligible insured described in paragraph 
(2)(B)(i) and, with respect to plan years beginning on 
or after January 1, 2028, an eligible insured described 
in paragraph (2)(B)(ii)''; and
(B) by amending subclauses (III) and (IV) to read 
as follows:
``(III) with respect to plan years 
beginning before January 1, 2028--
``(aa) 73 percent in the 
case of an eligible insured 
whose household income is more 
than 200 percent but not more 
than 250 percent of the poverty 
line for a family of the size 
involved; and
``(bb) 70 percent in the 
case of an eligible insured 
whose household income is more 
than 250 percent but not more 
than 400 percent of the poverty 
line for a family of the size 
involved; and
``(IV) with respect to plan years 
beginning on or after January 1, 2028, 
85 percent in the case of an eligible 
insured described in paragraph 
(2)(C)(ii).'';
(3) in subsection (c)(2), by amending subparagraphs (B) and 
(C) to read as follows:
``(B) in the case of--
``(i) with respect to plan years beginning 
before January 1, 2028, an eligible insured 
whose household income is more than 150 percent 
but not more than 200 percent of the poverty 
line for a family of the size involved, 
increase the plan's share of the total allowed 
costs of benefits provided under the plan to 87 
percent of such costs; and
``(ii) with respect to plan years beginning 
on or after January 1, 2028, an eligible 
insured whose household income is more than 150 
percent but not more than 300 percent of the 
poverty line for a family of the size involved, 
increase the plan's share of the total allowed 
costs of benefits provided under the plan to 87 
percent of such costs; and
``(C) in the case of--
``(i) with respect to plan years beginning 
before January 1, 2028, an eligible insured 
whose household income is more than 200 percent 
but not more than 250 percent of the poverty 
line for a family of the size involved, 
increase the plan's share of the total allowed 
costs of benefits provided under the plan to 73 
percent of such costs; and
``(ii) with respect to plan years beginning 
on or after January 1, 2028, an eligible 
insured whose household income is more than 300 
percent but not more than 400 percent of the 
poverty line for a family of the size involved, 
increase the plan's share of the total allowed 
costs of benefits provided under the plan to 85 
percent of such costs.''; and
(4) by adding at the end the following new subsection:
``(h) Funding.--Out of any funds in the Treasury not otherwise 
appropriated, there are appropriated to the Secretary such sums as may 
be necessary for payments under this section.''.
(b) Conforming Amendments to State Basic Health Programs for 
Certain Low-Income Individuals.--Section 1331(a)(2) of the Patient 
Protection and Affordable Care Act (42 U.S.C. 18051(a)(2)) is amended--
(1) in subparagraph (A)(i), by striking ``the applicable 
second lowest cost silver plan (as defined in section 
36B(b)(3)(B) of the Internal Revenue Code of 1986)'' and 
inserting ``, with respect to plan years beginning before 
January 1, 2028, the applicable second lowest cost silver plan 
(as defined in section 36B(b)(3)(B) of the Internal Revenue 
Code of 1986) and, with respect to plans years beginning on or 
after January 1, 2028, the applicable second lowest cost gold 
plan (as defined in such section)''; and
(2) in the matter following subparagraph (B), by striking 
``or the applicable second lowest cost silver plan'' and 
inserting ``or, with respect to plan years beginning before 
January 1, 2028, the applicable second lowest cost silver plan 
(or, with respect to plan years beginning on or after January 
1, 2028, the applicable second lowest cost gold plan''.

SEC. 3. PREMIUM ASSISTANCE CREDIT AMOUNT DETERMINED USING APPLICABLE 
SECOND LOWEST COST GOLD PLAN.

(a) In General.--Section 36B of the Internal Revenue Code of 1986 
is amended--
(1) by striking ``silver'' each place it appears and 
inserting ``gold''; and
(2) in the header of subsection (b)(3)(B), by striking 
``silver'' and inserting ``gold''.
(b) Effective Date.--The amendments made by this section shall 
apply to taxable years beginning after December 31, 2027.
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