Capping Costs for Consumers Act of 2026
Sponsored By: Representative Schrier
Introduced
Summary
Shifts cost-sharing and premium tax credit calculations from silver to gold plans starting in 2028. This would change how cost-sharing reductions (CSRs) are calculated, reset income bands and CSR percentages, and authorize Treasury funds to pay those CSR amounts.
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- Families and consumers: Cost-sharing and subsidy rules would use a gold-plan reference for post-2027 years. The bill sets CSR shares like 87% for some income bands and 85% for higher bands.
- Health plans and Exchanges: Premium tax credit calculations would use the applicable second-lowest cost gold plan for taxable years after 2027. Exchanges would apply new CSR percentages tied to those gold benchmarks.
- States and Basic Health Programs: State Basic Health Programs would switch their reference from the second-lowest cost silver plan to the second-lowest cost gold plan for plan years after 2027.
*Would increase federal spending by authorizing "such sums as may be necessary" from the Treasury to fund these cost-sharing reduction payments.*
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Bill Overview
Analyzed Economic Effects
2 provisions identified: 1 benefits, 0 costs, 1 mixed.
Lower out of pocket costs for low-income
If enacted, this bill would lower cost-sharing for people eligible for cost-sharing reductions (CSR) on the health Exchange. For plan years starting before Jan 1, 2028 it would set plan-share rates at 87% for incomes >150%–≤200% FPL, 73% for >200%–≤250% FPL, and 70% for >250%–≤400% FPL. For plan years starting on or after Jan 1, 2028 it would set plan-share rates at 87% for >150%–≤300% FPL and 85% for >300%–≤400% FPL. The bill would also appropriate such sums as may be necessary from the Treasury to the HHS Secretary to make CSR payments upon enactment.
Gold benchmark for health subsidies
If enacted, the bill would make the premium tax credit use the second-lowest-cost gold plan instead of silver for taxable years beginning after Dec 31, 2027. This would change how your premium tax credit is calculated and would raise or lower your credit depending on local gold versus silver prices. For plan years starting on or after Jan 1, 2028 State Basic Health Programs would also use the second-lowest-cost gold plan instead of silver, which would change BHP payment or reference amounts.
Sponsors & CoSponsors
Sponsor
Schrier
WA • D
Cosponsors
Budzinski
IL • D
Sponsored 1/20/2026
Roll Call Votes
No roll call votes available for this bill.
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