H.Res. 902

[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H. Res. 902 Introduced in House (IH)]

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119th CONGRESS
1st Session
H. RES. 902

Providing for consideration of the bill (H.R. 185) to advance 
responsible policies.

_______________________________________________________________________

IN THE HOUSE OF REPRESENTATIVES

November 20, 2025

Mr. Suozzi (for himself and Mr. Bacon) submitted the following 
resolution; which was referred to the Committee on Rules

_______________________________________________________________________

RESOLUTION

Providing for consideration of the bill (H.R. 185) to advance 
responsible policies.

Resolved, That immediately upon adoption of this resolution, the 
House shall proceed to the consideration in the House of the bill (H.R. 
185) to advance responsible policies. All points of order against 
consideration of the bill are waived. The amendment in the nature of a 
substitute specified in section 4 of this resolution shall be 
considered as adopted. The bill, as amended, shall be considered as 
read. All points of order against provisions in the bill, as amended, 
are waived. The previous question shall be considered as ordered on the 
bill, as amended, and on any further amendment thereto, to final 
passage without intervening motion except: (1) one hour of debate 
equally divided and controlled by the majority leader and minority 
leader or their respective designees; and (2) one motion to recommit.
Sec. 2. Clause 1(c) of rule XIX and clause 8 of rule XX shall not 
apply to the consideration of H.R. 185.
Sec. 3. The Clerk shall transmit to the Senate a message that the 
House has passed H.R. 185 no later than one calendar day after passage.
Sec. 4. The amendment in the nature of a substitute referred to in 
the first section of this resolution is as follows:
Strike all after the enacting clause and insert the 
following:

``SECTION 1. SHORT TITLE.

``This Act may be cited as the `Bipartisan Healthcare Optimization, 
Protection, and Extension Act' or the `HOPE 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) After 2025.--In the case of 
a taxable year beginning after December 
31, 2025, and before January 1, 2028--
```(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 800% 8.5% 9.0%
800% up to 935% 9.0% 9.35%''.
----------------------------------------------------------------------------------------------------------------

``(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) After 2025.--In the case of a 
taxable year beginning after December 31, 2025, 
and before January 1, 2028, subparagraph (A) 
shall be applied by substituting ``but does not 
exceed 935 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 for cause 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.

``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 May 15, 2026.''.
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