This bill makes several changes to how health insurance works under the Affordable Care Act, with most changes taking effect between 2026 and 2028. The main focus is on two areas: making health insurance more affordable for some people, and cracking down on fraud and misconduct by insurance agents and brokers.

On the affordability side, the bill temporarily increases tax credits that help people pay for health insurance premiums. Specifically, it raises the income threshold used to calculate these credits, which means more people could qualify for help paying their insurance costs, or people already getting help might receive larger subsidies. These changes apply to tax years 2026 and 2027.

The bill also makes significant changes to how Medicare Advantage plans are paid and evaluated. It requires the government to use more recent health data when calculating payments to these plans and prevents plans from inflating their payments by counting diagnoses that come only from chart reviews or health assessments rather than actual medical claims. The government will also have to study and report on differences in how Medicare Advantage plans versus traditional Medicare providers code medical conditions, to ensure fair payment comparisons.

Finally, the bill strengthens oversight of insurance agents and brokers who help people enroll in health plans. It creates new penalties for agents and brokers who provide false information—ranging from $10,000 to $50,000 in civil penalties, and up to 10 years in prison for knowingly providing fraudulent information. The bill also requires a verification process to confirm that people actually authorized their enrollment or plan changes, and it allows new types of marketing organizations to participate in enrollment while holding them to the same standards. The government will conduct audits of agents and brokers based on complaints and suspicious enrollment patterns, and will maintain a list of suspended or terminated agents for plans and states to access.