# Plain Language Summary: Protecting Health Care and Lowering Costs Act of 2025

This bill makes changes to how people qualify for help paying their health insurance premiums through tax credits. Currently, people earning more than 400% of the federal poverty line (roughly $115,000 for a family of four) don't qualify for any financial assistance with their insurance costs. This bill removes that income cap, meaning people earning above 400% of the poverty line can now get some help paying for their health insurance premiums, though the amount of assistance decreases as income increases.

The bill also changes how much people at different income levels are expected to contribute toward their insurance premiums. For people earning between 150% and 400% of the poverty line, the bill sets up a sliding scale where the percentage of income they're expected to pay gradually increases from 0% up to 8.5% depending on their exact income level. For people earning above 400% of the poverty line, they would pay a flat 8.5% of their income toward premiums. This means middle and upper-middle-income families who previously got no help would now receive some tax credits to offset their insurance costs, though they'd still be responsible for a percentage of the premium.

The bill also repeals certain health-related provisions from previous legislation, though the specific details of what's being removed aren't fully spelled out in this text. These changes would take effect for tax years beginning after December 31, 2025, meaning they'd first apply to people's 2026 taxes and health insurance coverage.

Protecting Health Care and Lowering Costs Act of 2025

Gray, Adam

Protecting Health Care and Lowering Costs Act 2025This bill makes permanent temporary provisions that generally expand eligibility for and increase the amount of the premium tax credit.&nbsp;This bill also repeals multiple Medicaid, Medicare, and health-related tax provisions enacted by the One Big Beautiful Bill Act (OBBBA).Currently, eligible taxpayers may claim the premium tax credit, which applies toward the cost of obtaining health insurance through health insurance exchanges. To qualify, a taxpayer’s household income must meet or exceed 100% of the federal poverty level (FPL) and, after 2025, may not exceed 400% of the FPL (maximum income limit). For 2021-2025, the maximum income limit is eliminated, which generally expands eligibility for the premium tax credit.Further, under current law, the amount of the premium tax credit is partially based on the taxpayer’s household income multiplied by the applicable percentage. The applicable percentage varies depending on which of six income ranges (adjusted for inflation after 2025) the taxpayer’s household income falls within. For 2021-2025, the applicable percentages are lowered and the adjustment of the applicable percentages for inflation is eliminated, which generally increases the amount of the premium tax credit.The bill permanently eliminates the 400% maximum income limit, lowers the applicable percentages, and eliminates the inflation adjustment for the applicable percentages.Finally, the bill repeals multiple Medicaid, Medicare, and health-related tax provisions enacted by the OBBBA, including<ul><li>certain Medicare and Medicare eligibility and verification requirements,</li><li>the reduced window for retroactive Medicaid coverage, and</li><li>premium tax credit verification requirements.</li></ul>