# Plain Language Summary: Capping Costs for Consumers Act of 2021

This bill makes health insurance more affordable for middle and lower-income Americans by reducing the out-of-pocket costs they have to pay when they get medical care. Right now, people buying insurance through the Affordable Care Act marketplace have to pay deductibles, copays, and coinsurance (a percentage of medical bills). This bill lowers those costs for people earning between roughly 150% and 400% of the poverty line—which means individuals making roughly $20,000 to $53,000 per year, depending on family size.

Starting in 2023, the bill changes how insurance companies calculate what they'll cover. Currently, the law bases these calculations on "silver" level plans, which are mid-tier insurance options. The bill shifts this to "gold" level plans, which are more comprehensive and cover more of your medical costs. This means insurance companies will have to pay for a larger share of your healthcare expenses, leaving you with smaller bills. For example, someone earning between 150% and 300% of the poverty line would see their insurance cover 87% of allowed medical costs instead of the current lower percentage. People earning between 300% and 400% of the poverty line would see coverage increase to 85%.

The bill also adjusts tax credits that help people afford premiums (monthly insurance payments), making those credits more generous starting in 2023. This means lower monthly bills for people buying insurance on their own. The government will cover the costs of these expanded benefits through general Treasury funds. Essentially, this bill makes marketplace insurance significantly cheaper for working and middle-class Americans by having insurance plans cover more of the actual medical bills people face.

Capping Costs for Consumers Act of 2021

Capping Costs for Consumers Act of 2021 This bill expands and provides funding for assistance to certain individuals who enroll in plans through health insurance exchanges. Specifically, it increases the premium assistance tax credit by revising, from the second-lowest cost silver plan to the second-lowest cost gold plan, the benchmark plan on which the credit amount is based. The bill also requires individuals to enroll in a gold plan to be eligible for cost-sharing reductions and it extends the reductions to individuals with a higher maximum household income. These changes apply to plan and tax years beginning on or after January 1, 2023.