CommonGround for Affordable Health Care Act
Sponsored By: Representative Kiggans (VA)
Introduced
Summary
expand the enhanced premium tax credit while adding fraud guardrails for agents and new transparency rules for pharmacy benefit managers. This bill would raise eligibility for advance credits and tighten enrollment and PBM oversight to protect consumers and federal programs.
Show full summary
- Families and households: The bill would raise the advance premium tax credit income cap for 2026 from 400% of the Federal Poverty Line to 1000% and set a 2026 premium-percent table that reduces required premium shares at lower incomes.
- Consumers and Exchanges: It would require verification for agent-submitted enrollments, quarterly checks for deceased enrollees, advance notice of premium tax credit amounts starting 2027, and an extended open enrollment from Nov. 1, 2025 to Mar. 19, 2026.
- Agents and brokers: New standards would impose civil penalties of $10,000 to $50,000 for negligence, up to $200,000 for knowing violations, and criminal penalties including fines and up to 10 years imprisonment for willful misconduct.
- PBMs, plans, and Medicare enrollees: The bill would force broad PBM definitions, strict limits on remuneration, annual machine‑readable reporting, mandatory audits, and apply many rules to Medicare Part D and MA‑PD plans for plan years beginning on or after Jan. 1, 2029.
*It would appropriate $113 million to the CMS Program Management Account and $20 million to the HHS Inspector General for FY2026 to implement PBM provisions.*
Your PRIA Score
Personalized for You
How does this bill affect your finances?
Sign up for a PRIA Policy Scan to see your personalized alignment score for this bill and every other piece of legislation we track. We analyze your financial profile against policy provisions to show you exactly what matters to your wallet.
Bill Overview
Analyzed Economic Effects
5 provisions identified: 4 benefits, 0 costs, 1 mixed.
New limits on Medicare drug middlemen
Starting with plan years on or after January 1, 2029, pharmacy benefit managers for Medicare drug plans would only be paid flat, fair‑market service fees. They would have to file detailed, machine‑readable reports for each plan and drug by July 1 each year, allow audits, and return improper payments. The same rules would also apply to Medicare Advantage plans with drug coverage. To enforce this, the bill would provide $113 million to CMS and $20 million to the HHS Inspector General for fiscal year 2026.
Bigger 2026 Marketplace premium tax credits
For the 2026 tax year only, the bill would let households with income up to 1,000% of the poverty line get the premium tax credit. It would also set a special 2026 table for your expected share of premiums. Up to 150% FPL: 0.0%; 150–200%: 0.0%–2.0%; 200–250%: 2.0%–4.0%; 250–300%: 4.0%–6.0%. 300–400%: 6.0%–8.5%; 400–600%: 8.5%; 600–900%: 8.5%–9.25%; 900–1000%: 9.25%–10.0%.
Longer 2026 Marketplace sign-up window
For plan year 2026, open enrollment would run from November 1, 2025 through March 19, 2026. The Secretary would also do outreach so people know about the longer window. This could make it easier to get coverage or change plans.
Stronger rules for Marketplace enrollments
The bill would set tough oversight for agents and brokers by January 1, 2029. Fines could be $10,000 to $50,000 per person for negligence and up to $200,000 per person for knowing fraud, plus up to 10 years in prison for willful fraud. Enrollments they submit would need verified consent, and commissions would be withheld until problems are fixed; consumers would get timely notices and be able to access account info. Starting January 1, 2027, Marketplaces would have to tell you your advance premium tax credit amount before you enroll. The Secretary would also check death records within 90 days and then quarterly to remove deceased enrollees, and Marketplaces would report when an insurer terminates.
Faster votes on premium savings bills
Congress would use a fast‑track process for certain bills that focus only on health insurance premium savings. To qualify, a bill would need at least 10 cosponsors from each party when offered. Debate and timing would be limited, and both Houses would have to vote by July 1, 2026. This speeds consideration but does not itself change your benefits.
Sponsors & CoSponsors
Sponsor
Kiggans (VA)
VA • R
Cosponsors
Gottheimer
NJ • D
Sponsored 12/10/2025
Lawler
NY • R
Sponsored 12/10/2025
Cuellar
TX • D
Sponsored 12/10/2025
Bresnahan
PA • R
Sponsored 12/10/2025
Suozzi
NY • D
Sponsored 12/10/2025
Mackenzie
PA • R
Sponsored 12/10/2025
Lee (NV)
NV • D
Sponsored 12/10/2025
Salazar
FL • R
Sponsored 12/10/2025
Landsman
OH • D
Sponsored 12/10/2025
Van Drew
NJ • R
Sponsored 12/10/2025
Case
HI • D
Sponsored 12/10/2025
Ciscomani
AZ • R
Sponsored 12/10/2025
Costa
CA • D
Sponsored 12/10/2025
Valadao
CA • R
Sponsored 12/10/2025
Riley (NY)
NY • D
Sponsored 12/10/2025
Hurd (CO)
CO • R
Sponsored 12/10/2025
Scholten
MI • D
Sponsored 12/10/2025
Bacon
NE • R
Sponsored 12/10/2025
Wilson (FL)
FL • D
Sponsored 12/10/2025
Gimenez
FL • R
Sponsored 12/10/2025
Goodlander
NH • D
Sponsored 12/10/2025
De La Cruz
TX • R
Sponsored 12/10/2025
Soto
FL • D
Sponsored 12/10/2025
LaLota
NY • R
Sponsored 12/10/2025
Gray
CA • D
Sponsored 12/10/2025
Kiley (CA)
CA • R
Sponsored 12/10/2025
Gonzalez, V.
TX • D
Sponsored 12/10/2025
Kean
NJ • R
Sponsored 12/10/2025
Figures
AL • D
Sponsored 12/10/2025
Fitzpatrick
PA • R
Sponsored 12/10/2025
Pappas
NH • D
Sponsored 12/10/2025
Liccardo
CA • D
Sponsored 12/10/2025
Davis (NC)
NC • D
Sponsored 12/10/2025
Moskowitz
FL • D
Sponsored 12/10/2025
Panetta
CA • D
Sponsored 12/10/2025
Peters
CA • D
Sponsored 12/10/2025
Golden (ME)
ME • D
Sponsored 12/10/2025
Perez
WA • D
Sponsored 12/11/2025
Roll Call Votes
No roll call votes available for this bill.
View on Congress.govTake It Personal
Get Your Personalized Policy View
Start a Free Government Policy Watch to see how policy affects your household, then upgrade to PRIA Full Coverage for year-round monitoring.
Already have an account? Sign in