H.R. 6760

119 HR 6760 IH: Protecting Access to Affordable Coverage Act of 2025
 U.S. House of Representatives
 2025-12-16
 text/xml
 EN
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 I  119th CONGRESS
  1st Session  H. R. 6760  IN THE HOUSE OF REPRESENTATIVES   December 16, 2025   Mr. Pappas  (for himself,  Ms. Norton ,  Ms. Goodlander , and  Ms. Johnson of Texas ) 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   A BILL
To amend the Patient Protection and Affordable Care Act to facilitate the enrollment of individuals in qualified health plans.
1.
Short title
This Act may be cited as the   Protecting Access to Affordable Coverage Act of 2025  .
2.
Facilitating the enrollment of individuals in qualified health plans
(a)
Extending the open enrollment period for plan year 2026
Section 1311(c)(6) of the Patient Protection and Affordable Care Act ( 42 U.S.C. 18031(c)(6) ) is amended-—
(1)
in subparagraph (B), by inserting  , subject to subparagraph (E),  after  as determined by the Secretary ;
(2)
in subparagraph (C), by striking  and  at the end;
(3)
in subparagraph (D), by striking the period and inserting  ; and ; and
(4)
by adding at the end the following new subparagraph:
(E)
an open enrollment period for enrollments for plan year 2026 that begins not later than November 1, 2025, and ends not earlier than May 1, 2026.
 .
(b)
Repeal of certain verification requirements
The amendments made by section 71303 of an Act to provide for reconciliation pursuant to title II of H. Con. Res. 14 ( Public Law 119–21 ) are repealed, and any provision of law amended by such section is restored or revived as if such amendments had never been enacted.
(c)
Ensuring enrollment opportunities for certain individuals
(1)
In general
 Section 36B(c)(3)(A)  of the Internal Revenue Code of 1986 is amended by striking clause (iii).
(2)
Establishment of special enrollment period
(A)
In general
Section 1311(c)(6) of the Patient Protection and Affordable Care Act ( 42 U.S.C. 18031(c)(6) ), as amended by subsection (a), is further amended—
(i)
in subparagraph (D), by striking  and  at the end;
(ii)
in subparagraph (E), by striking the period and inserting  ; and ; and
(iii)
by adding at the end the following new subparagraph:
(F)
a special enrollment period once per month for an individual who is eligible for the advance payment of premium tax credits under section 1412 and whose household income is not expected to exceed 150 percent of the poverty line for a family of the size involved.
 .
(B)
Effective date
The amendments made by subparagraph (A) shall apply with respect to plan years beginning on or after January 1, 2026.
(d)
Navigator grants
Section 1311(i) of the Patient Protection and Affordable Care Act ( 42 U.S.C. 18031(i) ) is amended—
(1)
in paragraph (2), by adding at the end the following new subparagraph:
(C)
Mandatory grant
In awarding grants under paragraph (1), the Exchange shall, for each plan year (beginning with plan year 2026)—
(i)
award such grants only to entities with a physical presence in the State of such Exchange; and
(ii)
award such a grant to at least 1 entity described in this paragraph.
 ;
(2)
in paragraph (4)(A)—
(A)
in the matter preceding clause (i), by inserting  (financial or otherwise)  after  interest ;
(B)
in clause (i), by striking  or  at the end;
(C)
in clause (ii), by striking the period and inserting  ; or ; and
(D)
by adding at the end the following new clause:
(iii)
for plan year 2026 or a subsequent plan year—
(I)
be an enhanced direct enrollment entity;
(II)
charge any fees to applicants or enrollees; or
(III)
request any form of remuneration from or on behalf of any applicant or enrollee.
 ; and
(3)
in paragraph (6)—
(A)
by striking
Funding.— Grants under  and inserting
Funding.—
(A)
State Exchanges
Grants under
 ; and
(B)
by adding at the end the following new subparagraph:
(B)
Federal Exchanges
(i)
In general
For purposes of carrying out this subsection, with respect to Exchanges established and operated by the Secretary pursuant to section 1321(c), the Secretary shall obligate $100,000,000 out of amounts collected through the user fees on participating health insurance issuers pursuant to section 156.50 of title 45, Code of Federal Regulations (or any successor regulations) for fiscal year 2026 and each subsequent fiscal year. Such amount for a fiscal year shall remain available until expended.
(ii)
Allocation
(I)
In general
The Secretary shall, out of amounts obligated under clause (i) for a fiscal year, allocate to each Exchange established and operated by the Secretary in a State pursuant to section 1321(c), for making grants under paragraph (1) during such fiscal year—
(aa)
$1,250,000; plus
(bb)
an amount that bears the same ratio to the total remaining obligated funds (as defined in subclause (II)) for such fiscal year as the number of individuals enrolled in a qualified health plan offered through an Exchange established in such State, or enrolled under the State plan of such State under title XIX (or waiver of such plan), during the preceding fiscal year bears to the total number of individuals enrolled in such a plan offered through an Exchange established in any State that is a specified State (as defined in subclause (II)) with respect to such fiscal year, or enrolled under the State plan of any such State under title XIX (or waiver of such plan), during such preceding fiscal year.
(II)
Definitions
In this clause:
(aa)
Total remaining obligated funds
The term  total remaining obligated funds  means, with respect to a fiscal year, $100,000,000, less an amount equal to the product of—
(AA)
$1,250,000; and
(BB)
the number of Exchanges described in clause (i) for such fiscal year.
(bb)
Specified State
The term  specified State  means, with respect to a fiscal year, a State in which the Secretary establishes and operates an Exchange pursuant to section 1321(c).
 .