HR6760119th CongressWALLET

Protecting Access to Affordable Coverage Act of 2025

Sponsored By: Representative Rep. Pappas, Chris [D-NH-1]

Introduced

Summary

This bill would make it easier to enroll in Affordable Care Act marketplace plans by expanding enrollment windows and creating targeted special enrollment and funding rules. It focuses on a longer open enrollment for plan year 2026, monthly special enrollment for very low-income people, stronger navigator rules, and a dedicated funding stream for federal Exchanges.

Show full summary
  • Families and low-income shoppers would gain a monthly special enrollment period if they are eligible for advance premium tax credits and their household income is not expected to exceed 150% of the poverty line. It would also strike a limiting clause from the premium tax credit rules in the tax code.
  • Consumers choosing plans for 2026 would see a defined open enrollment window that would begin no later than November 1, 2025 and end no earlier than May 1, 2026 for that plan year.
  • Exchanges and navigators would face new requirements and funding changes. Navigator grants would be limited to entities with a physical presence in the State and grant recipients could not charge fees to applicants or enrollees. The bill would set aside $100 million each year from issuer user fees and provide a baseline grant of $1.25 million per Exchange, with the rest allocated by enrollment formulas.

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Bill Overview

Analyzed Economic Effects

4 provisions identified: 3 benefits, 0 costs, 1 mixed.

More monthly enrollment and subsidies

If enacted, the bill would remove a limiting clause from the premium tax credit rules and expand who can get advance premium tax credits. If enacted, the bill would also create a special enrollment period available once each month for people who are eligible for advance payments of premium tax credits and whose household income is expected to be at or below 150% of the poverty line. These changes would apply for plan years beginning on or after January 1, 2026.

More local navigators and steady funding

If enacted, the government would set aside $100 million per year from issuer user fees beginning in fiscal year 2026 to fund navigator grants for federally run Exchanges. Each federal Exchange would get a $1,250,000 baseline plus a share of the remaining funds based on prior-year enrollment. For plan years 2026 and later, Exchanges must award grants only to groups with a physical in-state presence, must fund at least one in-state group, and grantees could not be enhanced direct enrollment entities or charge fees or seek payment from applicants or enrollees.

Restore prior enrollment verification rules

If enacted, the bill would repeal the verification changes made by section 71303 of H. Con. Res. 14 and restore the prior verification rules for Exchanges. That would change how people prove eligibility for Exchange coverage and Medicaid and could speed some enrollments while changing the administrative checks others face.

Longer open enrollment for 2026

If enacted, the open enrollment period for plan year 2026 would have to start no later than November 1, 2025 and run at least until May 1, 2026. That would give people more time to sign up for 2026 qualified health plans.

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Sponsors & CoSponsors

Sponsor

Rep. Pappas, Chris [D-NH-1]

NH • D

Cosponsors

  • Del. Norton, Eleanor Holmes [D-DC-At Large]

    DC • D

    Sponsored 12/16/2025

  • Rep. Goodlander, Maggie [D-NH-2]

    NH • D

    Sponsored 12/16/2025

  • Rep. Johnson, Julie [D-TX-32]

    TX • D

    Sponsored 12/16/2025

  • Rep. Salinas, Andrea [D-OR-6]

    OR • D

    Sponsored 12/17/2025

  • McClain Delaney

    MD • D

    Sponsored 1/13/2026

Roll Call Votes

No roll call votes available for this bill.

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