II
118THCONGRESS
1
STSESSION S. 8
To amend the Internal Revenue Code of 1986 to expand eligibility for the
refundable credit for coverage under a qualified health plan, to improve
cost-sharing subsidies under the Patient Protection and Affordable Care
Act, and for other purposes.
IN THE SENATE OF THE UNITED STATES
JANUARY23 (legislative day, JANUARY3), 2023
Mrs. S
HAHEEN(for herself, Mr. BLUMENTHAL, Ms. SMITH, Ms. BALDWIN,
Mr. K
AINE, Mr. REED, Mr. CASEY, Ms. STABENOW, Ms. KLOBUCHAR,
Mr. C
ARDIN, Ms. HASSAN, Mr. BENNET, Ms. CORTEZMASTO, and Mrs.
G
ILLIBRAND) introduced the following bill; which was read twice and re-
ferred to the Committee on Finance
A BILL
To amend the Internal Revenue Code of 1986 to expand
eligibility for the refundable credit for coverage under
a qualified health plan, to improve cost-sharing subsidies
under the Patient Protection and Affordable Care Act,
and for other purposes.
Be it enacted by the Senate and House of Representa-1
tives of the United States of America in Congress assembled, 2
SECTION 1. SHORT TITLE. 3
This Act may be cited as the ‘‘Improving Health In-4
surance Affordability Act of 2023’’. 5
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SEC. 2. INCREASE IN ELIGIBILITY FOR CREDIT. 1
(a) I
NGENERAL.—Subparagraph (A) of section 2
36B(c)(1) of the Internal Revenue Code of 1986 is amend-3
ed by striking ‘‘but does not exceed 400 percent’’. 4
(b) A
PPLICABLEPERCENTAGES.— 5
(1) I
N GENERAL.—Subparagraph (A) of section 6
36B(b)(3) of the Internal Revenue Code of 1986 is 7
amended to read as follows: 8
‘‘(A) A
PPLICABLE PERCENTAGE .—The ap-9
plicable percentage for any taxable year shall be 10
the percentage such that the applicable percent-11
age for any taxpayer whose household income is 12
within an income tier specified in the following 13
table shall increase, on a sliding scale in a lin-14
ear manner, from the initial premium percent-15
age to the final premium percentage specified in 16
such table for such income tier: 17
‘‘In the case of household income
(expressed as a percent of poverty line)
within the following income tier:
The initial
premium
percentage
is—
The final
premium
percentage
is—
Up to 150 percent .................................................. 0 0
150 percent up to 200 percent ............................... 0 2.0
200 percent up to 250 percent ............................... 2.0 4.0
250 percent up to 300 percent ............................... 4.0 6.0
300 percent up to 400 percent ............................... 6.0 8.5
400 percent and up ................................................ 8.5 8.5.’’.
(2) CONFORMING AMENDMENTS RELATING TO 18
AFFORDABILITY OF COVERAGE .— 19
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(A) Subparagraph (C) of section 36B(c)(2) 1
of such Code is amended by striking clause (iv). 2
(B) Paragraph (4) of section 36B(c) of 3
such Code is amended by striking subparagraph 4
(F). 5
(c) L
IMITATION ONRECAPTURE.—Clause (i) of sec-6
tion 36B(f)(2)(B) of the Internal Revenue Code of 1986 7
is amended— 8
(1) by striking ‘‘400 percent’’ and inserting 9
‘‘800 percent’’; 10
(2) by striking the period at the end of the last 11
row of the table; and 12
(3) by adding at the end of the table the fol-13
lowing new rows: 14
‘‘At least 400 percent but less than 600 percent ........................... $3,500
At least 600 percent but less than 800 percent ............................ $4,500.’’.
(d) PREMIUMCOSTSTANDARD.— 15
(1) I
N GENERAL.—The following provisions of 16
section 36B of the Internal Revenue Code of 1986 17
are each amended by striking ‘‘silver’’ each place it 18
appears and inserting ‘‘gold’’: 19
(A) Paragraphs (2)(B)(i), (3)(B), and 20
(3)(C) of subsection (b). 21
(B) The heading of subparagraph (B) of 22
subsection (b)(3). 23
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(C) Subsection (c)(4)(C)(i)(I). 1
(2) C
ONFORMING AMENDMENTS TO REDUCED 2
COST-SHARING.—Section 1402(b)(1) of the Patient 3
Protection and Affordable Care Act (42 U.S.C. 4
18071(b)(1)) is amended by striking ‘‘silver’’ and in-5
serting ‘‘gold’’. 6
(e) E
FFECTIVEDATE.—The amendments made by 7
this section shall apply to taxable years beginning after 8
December 31, 2023. 9
SEC. 3. ENHANCEMENTS FOR REDUCED COST-SHARING. 10
(a) M
ODIFICATION OFAMOUNT.— 11
(1) I
N GENERAL.—Section 1402(c)(2) of the 12
Patient Protection and Affordable Care Act (42 13
U.S.C. 18071(c)(2)) is amended— 14
(A) by striking ‘‘150 percent’’ in subpara-15
graph (A) and inserting ‘‘200 percent’’, 16
(B) by striking ‘‘94 percent’’ in subpara-17
graph (A) and inserting ‘‘95 percent’’, 18
(C) by striking ‘‘150 percent but not more 19
than 200 percent’’ in subparagraph (B) and in-20
serting ‘‘200 percent but not more than 300 21
percent’’, 22
(D) by striking ‘‘87 percent’’ in subpara-23
graph (B) and inserting ‘‘90 percent’’, 24
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(E) by striking ‘‘200 percent’’ in subpara-1
graph (C) and inserting ‘‘300 percent’’, 2
(F) by striking ‘‘250 percent’’ in subpara-3
graph (C) and inserting ‘‘400 percent’’, and 4
(G) by striking ‘‘73 percent’’ in subpara-5
graph (C) and inserting ‘‘85 percent’’. 6
(2) C
ONFORMING AMENDMENT .—Clause (i) of 7
section 1402(c)(1)(B) of such Act (42 U.S.C. 8
18071(c)(1)(B)) is amended to read as follows: 9
‘‘(i) I
N GENERAL.—The Secretary 10
shall ensure the reduction under this para-11
graph shall not result in an increase in the 12
plan’s share of the total allowed costs of 13
benefits provided under the plan above— 14
‘‘(I) 95 percent in the case of an 15
eligible insured described in para-16
graph (2)(A); 17
‘‘(II) 90 percent in the case of an 18
eligible insured described in para-19
graph (2)(B); and 20
‘‘(III) 85 percent in the case of 21
an eligible insured described in para-22
graph (2)(C).’’. 23
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(3) EFFECTIVE DATE.—The amendments made 1
by this subsection shall apply to plan years begin-2
ning after December 31, 2023. 3
(b) F
UNDING.—Section 1402 of the Patient Protec-4
tion and Affordable Care Act (42 U.S.C. 18071) is amend-5
ed by adding at the end the following new subsection: 6
‘‘(g) F
UNDING.—Out of any funds in the Treasury 7
not otherwise appropriated, there are appropriated to the 8
Secretary such sums as may be necessary for payments 9
under this section.’’. 10
Æ
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