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HR 4849119th CongressIn Committee

Protecting Health Care and Lowering Costs Act of 2025

Introduced: Aug 1, 2025
Sponsor: Rep. Gray, Adam [D-CA-13] (D-California)
Healthcare
Standard Summary
Comprehensive overview in 1-2 paragraphs

The Protecting Health Care and Lowering Costs Act of 2025, introduced by Representative Gray, consists of two primary parts. First, it repeals the health-related provisions included in Subtitle B of Title VII of Public Law 119-21 (the reconciliation package). In practical terms, that means those health provisions would be treated as if they had never been enacted. Second, the bill expands eligibility for the premium tax credit (PTC) under the Affordable Care Act by removing the previous 400% of the federal poverty line (FPL) cap and establishing a new, income-based, graduated credit schedule. The changes would apply to tax years beginning after December 31, 2025 (i.e., starting with the 2026 plan year). The net effect is to undo certain health-related provisions from the reconciliation package while broadening and recalibrating subsidies to help more people pay for health insurance bought through the ACA marketplaces.

Key Points

  • 1Repeal of reconciliation health provisions: Subsection identified as Subtitle B of Title VII of Public Law 119-21 is repealed; any law or regulation tied to that subtitle is treated as if the subtitle had not been enacted.
  • 2Expanded PTC eligibility: Eliminates the 400% of poverty line cap for premium tax credits, enabling subsidies for households with higher incomes than prior limits.
  • 3New subsidy structure: Introduces a sliding, income-tiered “applicable percentage” to determine the share of income attributed to premiums, with a table that phases in subsidies from 0% at or below 150% FPL up to 8.5% for incomes 400% FPL and higher.
  • 4Effective date: Changes to premium tax credits apply to taxable years beginning after December 31, 2025 (tax year 2026 and beyond).
  • 5Legislative framing: The bill explicitly states that the health-related provisions repealed are treated as though they were never enacted, thereby nullifying those elements of the reconciliation package.

Impact Areas

Primary group/area affected: Individuals and families purchasing health insurance through ACA marketplace plans, especially those in low- to middle-income brackets who would benefit from expanded premium tax credits.Secondary group/area affected: Federal budget and spending on health insurance subsidies (potentially increasing outlays due to broader eligibility and higher subsidies); health insurers participating in ACA marketplaces; state insurance marketplaces and administration.Additional impacts: Changes in consumer premium shares and net premiums could influence enrollment decisions and plan choices; potential administrative and regulatory implications as agencies adjust to the repeal of certain reconciliation provisions and the new subsidy framework.
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