Amendment of Subsection (c)(3)(A)Pub. L. 119–21, title VII, § 71303(b), (c),
July 4, 2025, 139 Stat. 324, provided that, applicable to taxable years beginning after Dec. 31, 2027, subsection (c)(3)(A) of this section is amended as follows: (1) by striking “health plan.—The term” and inserting “health plan “(i) In general “The term”, and (2) by adding at the end the following new clause: “(ii) Pre-enrollment verification process required “Such term shall not include any plan enrolled in through an Exchange, unless such Exchange provides a process for pre-enrollment verification through which any applicant may, beginning not later than August 1, verify with the Exchange the applicant’s household income and eligibility for enrollment in such plan for plan years beginning in the subsequent year.” See 2025 Amendment notes below. Amendment of Subsection (c)(5), (6)Pub. L. 119–21, title VII, § 71303(a), (c),
July 4, 2025, 139 Stat. 323, 324, provided that, applicable to taxable years beginning after Dec. 31, 2027, subsection (c) of this section is amended by adding at the end the following new paragraphs: “(5) Exchange enrollment verification requirement “(A) In general “The term ‘coverage month’ shall not include, with respect to any individual covered by a qualified health plan enrolled in through an Exchange, any month beginning before the Exchange verifies, using applicable enrollment information that shall be provided or verified by the applicant, such individual’s eligibility— “(i) to enroll in the plan through the Exchange, and “(ii) for any advance payment under
section 1412 of the Patient Protection and Affordable Care Act of the credit allowed under this section. “(B) Applicable enrollment information “For purposes of subparagraph (A), applicable enrollment information shall include affirmation of at least the following information (to the extent relevant in determining eligibility described in subparagraph (A)): “(i) Household income and family size. “(ii) Whether the individual is an eligible alien. “(iii) Any health coverage status or eligibility for coverage. “(iv) Place of residence. “(v) Such other information as may be determined by the Secretary (in consultation with the Secretary of Health and Human Services) as necessary to the verification prescribed under subparagraph (A). “(C) Verification of past months “In the case of a month that begins before verification prescribed by subparagraph (A), such month shall be treated as a coverage month if the Exchange verifies for such month (using applicable enrollment information that shall be provided or verified by the applicant) such individual’s eligibility to have so enrolled and for any such advance payment. “(D) Exchange participation; coordination with other procedures for determining eligibility “An individual shall not, solely by reason of failing to meet the requirements of this paragraph with respect to a month, be treated for such month as ineligible to enroll in a qualified health plan through an Exchange. “(E) Waiver for certain special enrollment periods “The Secretary may waive the application of subparagraph (A) in the case of an individual who enrolls in a qualified health plan through an Exchange for 1 or more months of the taxable year during a special enrollment period provided by the Exchange on the basis of a change in the family size of the individual. “(F) Information and reliance on third-party sources “An Exchange shall be permitted to use any data available to the Exchange and any reliable third-party sources in collecting information for verification by the applicant. “(6) Exchange compliance with filing requirements “The term ‘coverage month’ shall not include, with respect to any individual covered by a qualified health plan enrolled in through an Exchange, any month for which the Exchange does not meet the requirements of
section 155.305(f)(4)(iii) of title 45, Code of Federal
Regulations
(as published in the Federal Register on
June 25, 2025 (90 Fed. Reg. 27074), applied as though it applied to all plan years after 2025), with respect to the individual.” See 2025 Amendment notes below. Amendment of Subsection (e)Pub. L. 119–21, title VII, § 71301(a), (b), (e),
July 4, 2025, 139 Stat. 321, 322, provided that, applicable to taxable years beginning after Dec. 31, 2026, subsection (e) of this section is amended as follows: (1) in paragraph (1), by inserting “or, in the case of aliens who are lawfully present, are not eligible aliens” after “individuals who are not lawfully present”; and (2) in paragraph (2): (A) by striking “For purposes of this section, an individual” and inserting “For purposes of this section— “(A) In general “An individual”; and (B) by adding at the end the following new subparagraph: “(B) Eligible aliens “An individual who is an alien and lawfully present shall be treated as an eligible alien if such individual is, and is reasonably expected to be for the entire period of enrollment for which the credit under this section is being claimed— “(i) an alien who is lawfully admitted for permanent residence under the Immigration and Nationality Act (8 U.S.C. 1101 et seq.), “(ii) an alien who has been granted the status of Cuban and Haitian entrant, as defined in
section 501(e) of the Refugee Education Assistance Act of 1980 (Public Law 96–422); or “(iii) an individual who lawfully resides in the United States in accordance with a Compact of Free Association referred to in
section 402(b)(2)(G) of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (8 U.S.C. 1612(b)(2)(G)).” See 2025 Amendment notes below. Inflation Adjusted Items for Certain YearsFor inflation adjustment of certain items in this section, see Revenue Procedures listed in a table under
section 1 of this title.
References in Text
section 1251, 1301, 1302, 1311, 1321, 1402, and 1412 of the Patient Protection and Affordable Care Act, referred to in text, are classified to
section 18011, 18021, 18022, 18031, 18041, 18071, and 18082, respectively, of Title 42, The Public Health and Welfare.
section 1(c), referred to in subsecs. (b)(3)(B)(ii)(I)(aa) and (f)(2)(B)(i), to be treated, for purposes of the rate of tax, as a reference to the corresponding rate bracket under
section 1(j)(2)(C) of this title, see
section 1(j)(2)(F) of this title.
section 2701 and
2705(d) of the Public Health Service Act, referred to in subsec. (b)(3)(C), are classified to
section 300gg and
300gg–4(d), respectively, of Title 42, The Public Health and Welfare. The reference to
section 2705(d) probably should be a reference to
section 2705(l), which relates to wellness program demonstration project and is classified to
section 300gg–4(l) of Title 42.
section 1311(d)(2)(B)(ii)(I) of the Patient Protection and Affordable Care Act, referred to in subsec. (b)(3)(E), probably means
section 1311(d)(2)(B)(ii) of Pub. L. 111–148, which is classified to
section 18031(d)(2)(B)(ii) of Title 42, The Public Health and Welfare, and which does not contain subclauses. The Social Security Act, referred to in subsec. (c)(1)(B)(ii), is act Aug. 14, 1935, ch. 531, 49 Stat. 620. Title XIX of the Act is classified generally to subchapter XIX (§ 1396 et seq.) of chapter 7 of Title 42, The Public Health and Welfare. For complete classification of this Act to the Code, see
section 1305 of Title 42 and Tables.
Amendments
2025—Subsec. (c)(1)(B). Pub. L. 119–21, § 71302(a), struck out subpar. (B) which related to a special rule for certain individuals lawfully present in the United States for treatment as an applicable taxpayer. Subsec. (c)(3)(A). Pub. L. 119–21, § 71303(b), designated existing provisions as cl. (i), inserted heading, and added cl. (ii). Subsec. (c)(3)(A)(iii). Pub. L. 119–21, § 71304(a), added cl. (iii). Subsec. (c)(5), (6). Pub. L. 119–21, § 71303(a), added pars. (5) and (6). Subsec. (e)(1). Pub. L. 119–21, § 71301(a), inserted “or, in the case of aliens who are lawfully present, are not eligible aliens” after “individuals who are not lawfully present” in introductory provisions. Subsec. (e)(2). Pub. L. 119–21, § 71301(b), substituted “For purposes of this section—” for “For purposes of this section,”, designated remainder of existing provisions as subpar. (A), inserted heading, and added subpar. (B). Subsec. (f)(2). Pub. L. 119–21, § 71305(a), (b)(1), struck out subpar. (A) designation and heading and subpar. (B) which related to limitation on increase of advance payments under
section 1412 of the Patient Protection and Affordable Care Act to a taxpayer whose household income is less than 400 percent of the poverty line for the size of the family involved for the taxable year. 2022—Subsec. (b)(3)(A)(iii). Pub. L. 117–169, § 12001(a), substituted “2021 through 2025” for “2021 and 2022” in heading and “after
December 31, 2020, and before
January 1, 2026” for “in 2021 or 2022” in introductory provisions. Subsec. (c)(1)(E). Pub. L. 117–169, § 12001(b), substituted “2021 through 2025” for “2021 and 2022” in heading and “after
December 31, 2020, and before
January 1, 2026” for “in 2021 or 2022” in text. 2021—Subsec. (b)(3)(A)(iii). Pub. L. 117–2, § 9661(a), added cl. (iii). Subsec. (c)(1)(E). Pub. L. 117–2, § 9661(b), added subpar. (E). Subsec. (f)(2)(B)(iii). Pub. L. 117–2, § 9662(a), added cl. (iii). Subsecs. (g), (h). Pub. L. 117–2, § 9663(a), added subsec. (g) and redesignated former subsec. (g) as (h). 2017—Subsec. (f)(2)(B)(ii)(II). Pub. L. 115–97 substituted “for ‘calendar year 2016’ in subparagraph (A)(ii)” for “for ‘calendar year 1992’ in subparagraph (B)”. 2016—Subsec. (c)(4). Pub. L. 114–255 added par. (4). 2011—Subsec. (c)(2)(D). Pub. L. 112–10 struck out subpar. (D). Prior to amendment, text read as follows: “The term ‘coverage month’ shall not include any month in which such individual has a free choice voucher provided under
section 10108 of the Patient Protection and Affordable Care Act.” Subsec. (d)(2)(B)(iii). Pub. L. 112–56 added cl. (iii). Subsec. (f)(2)(B)(i). Pub. L. 112–9 amended cl. (i) generally. Prior to amendment, cl. (i) consisted of text and a table limiting increase in amount recovered on reconciliation of health insurance tax credit and advance of that credit for households with income below 500 percent of Federal poverty line. 2010—Subsec. (b)(3)(A)(i). Pub. L. 111–152, § 1001(a)(1)(A), substituted “for any taxable year shall be the percentage such that the applicable percentage for any taxpayer whose household income is within an income tier specified in the following table shall increase, on a sliding scale in a linear manner, from the initial premium percentage to the final premium percentage specified in such table for such income tier:” for “with respect to any taxpayer for any taxable year is equal to 2.8 percent, increased by the number of percentage points (not greater than 7) which bears the same ratio to 7 percentage points as—” in introductory provisions, inserted table, and struck out subcls. (I) and (II) which read as follows: “(I) the taxpayer’s household income for the taxable year in excess of 100 percent of the poverty line for a family of the size involved, bears to “(II) an amount equal to 200 percent of the poverty line for a family of the size involved.” Subsec. (b)(3)(A)(ii). Pub. L. 111–152, § 1001(a)(1)(B), added cl. (ii) and struck out former cl. (ii). Text read as follows: “If a taxpayer’s household income for the taxable year equals or exceeds 100 percent, but not more than 133 percent, of the poverty line for a family of the size involved, the taxpayer’s applicable percentage shall be 2 percent.” Pub. L. 111–148, § 10105(a), substituted “equals or exceeds” for “is in excess of”. Subsec. (b)(3)(A)(iii). Pub. L. 111–152, § 1001(a)(1)(B), struck out cl. (iii). Text read as follows: “In the case of taxable years beginning in any calendar year after 2014, the Secretary shall adjust the initial and final applicable percentages under clause (i), and the 2 percent under clause (ii), for the calendar year to reflect the excess of the rate of premium growth between the preceding calendar year and 2013 over the rate of income growth for such period.” Subsec. (c)(1)(A). Pub. L. 111–148, § 10105(b), inserted “equals or” before “exceeds”. Subsec. (c)(2)(C)(i)(II). Pub. L. 111–152, § 1001(a)(2)(A), substituted “9.5 percent” for “9.8 percent”. Subsec. (c)(2)(C)(iv). Pub. L. 111–152, § 1001(a)(2), substituted “9.5 percent” for “9.8 percent” and “(b)(3)(A)(ii)” for “(b)(3)(A)(iii)”. Pub. L. 111–148, § 10105(c), substituted “subsection (b)(3)(A)(iii)” for “subsection (b)(3)(A)(ii)”. Subsec. (c)(2)(D). Pub. L. 111–148, § 10108(h)(1), added subpar. (D). Subsec. (d)(2)(A)(i), (ii). Pub. L. 111–152, § 1004(a)(1)(A), substituted “modified adjusted gross” for “modified gross”. Subsec. (d)(2)(B). Pub. L. 111–152, § 1004(a)(2)(A), amended subpar. (B) generally. Prior to amendment, text read as follows: “The term ‘modified gross income’ means gross income— “(i) decreased by the amount of any deduction allowable under paragraph (1), (3), (4), or (10) of
section 62(a), “(ii) increased by the amount of interest received or accrued during the taxable year which is exempt from tax imposed by this chapter, and “(iii) determined without regard to
section 911, 931, and 933.” Subsec. (f)(2)(B). Pub. L. 111–309, § 208(a), amended generally subpar. heading and cl. (i). Prior to amendment, text of cl. (i) read as follows: “In the case of an applicable taxpayer whose household income is less than 400 percent of the poverty line for the size of the family involved for the taxable year, the amount of the increase under subparagraph (A) shall in no event exceed $400 ($250 in the case of a taxpayer whose tax is determined under
section 1(c) for the taxable year).” Subsec. (f)(2)(B)(ii). Pub. L. 111–309, § 208(b), inserted “in the table contained” after “each of the dollar amounts” in introductory provisions. Subsec. (f)(3). Pub. L. 111–152, § 1004(c), added par. (3).
Statutory Notes and Related Subsidiaries
Effective Date
of 2025 Amendment Pub. L. 119–21, title VII, § 71301(e), July 4, 2025, 139 Stat. 322, provided that: “The
Amendments
made by this section [amending this section and
section 5000A of this title] (other than the
Amendments
made by subsection (c) [amending
section 18081 and
18082 of title 42]) shall apply to taxable years beginning after
December 31, 2026.” Pub. L. 119–21, title VII, § 71302(b),
July 4, 2025, 139 Stat. 323, provided that: “The
Amendments
made by this section [amending this section] shall apply to taxable years beginning after
December 31, 2025.” Pub. L. 119–21, title VII, § 71303(c),
July 4, 2025, 139 Stat. 324, provided that: “The
Amendments
made by this section [amending this section] shall apply to taxable years beginning after
December 31, 2027.” Pub. L. 119–21, title VII, § 71304(b),
July 4, 2025, 139 Stat. 324, provided that: “The
Amendments
made by this section [amending this section] shall apply with respect to plan years beginning after December 31, 2025.” Amendment by
section 71305 of Pub. L. 119–21, applicable to taxable years beginning after Dec. 31, 2025, see
section 71305(c) of Pub. L. 119–21 set out as a note under
section 35 of this title.
Effective Date
of 2022 Amendment Pub. L. 117–169, title I, § 12001(c), Aug. 16, 2022, 136 Stat. 1906, provided that: “The
Amendments
made by this section [amending this section] shall apply to taxable years beginning after December 31, 2022.”
Effective Date
of 2021 Amendment Pub. L. 117–2, title IX, § 9661(c), Mar. 11, 2021, 135 Stat. 183, provided that: “The
Amendments
made by this section [amending this section] shall apply to taxable years beginning after
December 31, 2020.” Pub. L. 117–2, title IX, § 9662(b), Mar. 11, 2021, 135 Stat. 183, provided that: “The amendment made by this section [amending this section] shall apply to taxable years beginning after
December 31, 2019.” Pub. L. 117–2, title IX, § 9663(b), Mar. 11, 2021, 135 Stat. 184, provided that: “The
Amendments
made by this section [amending this section] shall apply to taxable years beginning after December 31, 2020.”
Effective Date
of 2017 AmendmentAmendment by Pub. L. 115–97 applicable to taxable years beginning after Dec. 31, 2017, see
section 11002(e) of Pub. L. 115–97, set out as a note under
section 1 of this title.
Effective Date
of 2016 Amendment Pub. L. 114–255, div. C, title XVIII, § 18001(a)(7), Dec. 13, 2016, 130 Stat. 1343, provided that: “(A) In general.—Except as otherwise provided in this paragraph, the
Amendments
made by this subsection [amending this section,
section 106, 4980I, 6051, 6652, and 9831 of this title, and
section 18081 of Title 42, The Public Health and Welfare] shall apply to years beginning after
December 31, 2016. “(B) Transition relief.—The relief under Treasury Notice 2015–17 shall be treated as applying to any plan year beginning on or before
December 31, 2016. “(C) Coordination with health insurance premium credit.—The
Amendments
made by paragraph (3) [amending this section] shall apply to taxable years beginning after December 31, 2016. “(D) Employee notice.—“(i) In general.—The
Amendments
made by paragraph (5) [amending
section 6652 of this title] shall apply to notices with respect to years beginning after December 31, 2016. “(ii) Transition relief.—For purposes of
section 6652(o) of the Internal Revenue Code of 1986 (as added by this Act), a person shall not be treated as failing to provide a written notice as required by
section 9831(d)(4) of such Code if such notice is so provided not later than 90 days after the date of the enactment of this Act [Dec. 13, 2016]. “(E) W–2 reporting.—The
Amendments
made by paragraph (6)(A) [amending
section 6051 of this title] shall apply to calendar years beginning after December 31, 2016. “(F) Information provided by exchange subsidy applicants.—“(i) In general.—The
Amendments
December 31, 2016. “(ii) Verification.—Verification under
section 1411 of the Patient Protection and Affordable Care Act [42 U.S.C. 18081] of information provided under
section 1411(b)(3)(B) of such Act shall apply with respect to months beginning after October 2016. “(iii) Transitional relief.—In the case of an application for enrollment under
section 1411(b) of the Patient Protection and Affordable Care Act [42 U.S.C. 18081(b)] made before
April 1, 2017, the requirement of
section 1411(b)(3)(B) of such Act shall be treated as met if the information described therein is provided not later than 30 days after the date on which the applicant receives the notice described in
section 9831(d)(4) of the Internal Revenue Code of 1986.”
Effective Date
of 2011 Amendment Pub. L. 112–56, title IV, § 401(b), Nov. 21, 2011, 125 Stat. 734, provided that: “The
Amendments
made by this section [amending this section] shall take effect on the date of the enactment of this Act [Nov. 21, 2011].” Pub. L. 112–10, div. B, title VIII, § 1858(d), Apr. 15, 2011, 125 Stat. 169, provided that: “The
Amendments
made by this section [amending this section,
section 162, 4980H, and 6056 of this title, and
section 218b of Title 29, Labor, and repealing
section 139D of this title and
section 18101 of Title 42, The Public Health and Welfare] shall take effect as if included in the provisions of, and the
Amendments
made by, the provisions of the Patient Protection and Affordable Care Act [Pub. L. 111–148] to which they relate.” Pub. L. 112–9, § 4(b), Apr. 14, 2011, 125 Stat. 37, provided that: “The amendment made by this section [amending this section] shall apply to taxable years ending after December 31, 2013.”
Effective Date
of 2010 Amendment Pub. L. 111–309, title II, § 208(c), Dec. 15, 2010, 124 Stat. 3292, provided that: “The
Amendments
made by this section [amending this section] shall apply to taxable years beginning after
December 31, 2013.” Pub. L. 111–148, title X, § 10108(h)(2), Mar. 23, 2010, 124 Stat. 914, provided that: “The amendment made by this subsection [amending this section] shall apply to taxable years beginning after
December 31, 2013.”
Effective Date
Pub. L. 111–148, title I, § 1401(e), Mar. 23, 2010, 124 Stat. 220, provided that: “The
Amendments
made by this section [enacting this section and amending
section 280C and
6211 of this title and
section 1324 of Title 31, Money and Finance] shall apply to taxable years ending after December 31, 2013.” Substantiation Requirements Pub. L. 114–255, div. C, title XVIII, § 18001(a)(8), Dec. 13, 2016, 130 Stat. 1343, provided that: “The Secretary of the Treasury (or his designee) may issue substantiation requirements as necessary to carry out this subsection [amending this section,
section 106, 4980I, 6051, 6652, and 9831 of this title, and
section 18081 of Title 42, The Public Health and Welfare, and enacting provisions set out as a note under this section].” No Impact on Social Security Trust Funds Pub. L. 112–56, title IV, § 401(c), Nov. 21, 2011, 125 Stat. 734, provided that: “(1) Estimate of secretary.—The Secretary of the Treasury, or the Secretary’s delegate, shall annually estimate the impact that the
Amendments
made by subsection (a) [amending this section] have on the income and balances of the trust funds established under
section 201 of the Social Security Act (42 U.S.C. 401). “(2) Transfer of funds.—If, under paragraph (1), the Secretary of the Treasury or the Secretary’s delegate estimates that such
Amendments
have a negative impact on the income and balances of such trust funds, the Secretary shall transfer, not less frequently than quarterly, from the general fund an amount sufficient so as to ensure that the income and balances of such trust funds are not reduced as a result of such
Amendments
.”