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119-s-3380119th CongressWALLET

ACA Marketplace Integrity Act

Sponsored By: Senator Marshall, Roger [R-KS]

Introduced

Summary

Tighten marketplace integrity by requiring at least a small monthly payment from people using premium tax credits and by adding stronger ID checks for adult enrollees. The bill also turns a 2025 Marketplace rule into statutory law to set the enrollment and affordability standards that will guide marketplaces and CMS.

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  • Families and workers who get premium tax credits must pay at least $5 per month toward their plan. This changes how monthly premium assistance is calculated and can reduce the government’s monthly contribution by up to $5 per enrollee.
  • Adults enrolling in qualified health plans must provide a government-issued photo ID and any additional documents CMS requires before enrollment. This raises identity verification steps for anyone age 18 or older.
  • Health insurance Marketplaces and CMS will operate under the codified final rule titled “Marketplace Integrity and Affordability” (June 25, 2025). That rule becomes the primary statutory framework for enrollment verification and affordability standards.

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Bill Overview

Analyzed Economic Effects

2 provisions identified: 0 benefits, 1 costs, 1 mixed.

Marketplace subsidies: $5 minimum share

If enacted, this would stop premium tax credits from covering the first $5 of each monthly premium. Your monthly premium assistance would be reduced so you pay at least $5 per coverage month. That is up to $60 less help per year for a household. This change would apply to every coverage month starting as of enactment.

Photo ID to enroll in Marketplace

If enacted, this would codify the final rule titled "Marketplace Integrity and Affordability" (90 Fed. Reg. 27074, June 25, 2025) into law. It would require each enrollee over age 18 to provide a government-issued photo ID for enrollment verification. CMS could also require other documents the Administrator deems necessary. These verification rules would take effect upon enactment.

Sponsors & CoSponsors

Sponsor

Marshall, Roger [R-KS]

KS • R

Cosponsors

  • Sen. Britt, Katie Boyd [R-AL]

    AL • R

    Sponsored 12/8/2025

Roll Call Votes

No roll call votes available for this bill.

View on Congress.gov
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