The ACCESS Act makes health insurance more affordable for lower-income Americans in two main ways. First, it temporarily expands the tax credit that helps people pay for health insurance premiums between 2024 and 2026. Currently, you can only get this credit if you earn between 100% and 400% of the federal poverty level (roughly $14,000 to $56,000 for an individual in 2024). The bill removes that upper income limit and also lets people earning up to 138% of the poverty level qualify for the credit, even if their employer offers them health insurance. This means more people will be able to afford coverage through the health insurance marketplace.

Second, starting in 2027, the bill creates a federal Medicaid program for states that haven't expanded Medicaid on their own. Currently, 10 states haven't expanded Medicaid to cover more low-income adults, leaving many people without affordable coverage options. This federal program would automatically extend Medicaid coverage to adults under 65 earning up to 138% of the federal poverty level in those states. The federal government would fund and manage this program through contracts with insurance companies and health plan administrators. Essentially, the bill aims to close coverage gaps by making tax credits more generous for a few years and ensuring that people in non-expansion states have access to Medicaid coverage.

ACCESS Act

Fletcher, Lizzie

Affordable Care Coverage Expansion and Support for States Act or the ACCESS Act This bill temporarily expands the health insurance premium tax credit. It also establishes a Federal Medicaid Program for states that have not yet expanded Medicaid to certain populations. Currently, in order to qualify for the health insurance premium tax credit, an individual must, among other criteria, have an annual household income of at least 100% and up to 400% of the federal poverty level and not be eligible for minimum essential coverage, such as affordable coverage through an employer. The bill removes the income limitations, and it allows individuals with income of up to 138% of the federal poverty level and who are eligible for employer-provided health insurance or small employer health reimbursement arrangements to qualify for the tax credit. The bill's changes apply for tax years 2024-2026. The bill also establishes and provides funds for a Federal Medicaid Program beginning in 2027 to provide coverage to the Medicaid expansion population in states that have not expanded Medicaid pursuant to the Patient Protection and Affordable Care Act. (The act allows states to extend Medicaid coverage to all adults under the age of 65 with incomes of up to 138% of the federal poverty level.) The program must offer at least the same benchmark coverage as under Medicaid. The Centers for Medicare &amp; Medicaid Services must contract with Medicaid managed care organizations or other third-party plan administrators to administer the program.