The CommonGround for Affordable Health Care Act makes several changes to how health insurance works under the Affordable Care Act, with effects stretching from 2026 through 2029 and beyond.

First, the bill extends and adjusts tax credits that help people afford health insurance premiums. Currently, these credits are set to expire after 2025, but this bill extends them into 2026 and 2027 with modified rules. Starting in 2027, the bill also requires health insurance exchanges to clearly tell people how much in tax credits they're eligible for before they enroll in a plan. The bill also extends the open enrollment period for 2026 coverage, running from November 1, 2025 through March 19, 2026—longer than the typical period.

Second, the bill cracks down on fraud and improper conduct by insurance agents, brokers, and marketing organizations. It creates new penalties for agents and brokers who provide false information or fail to get proper consent from customers before enrolling them in plans. The bill requires verification processes to ensure people actually want the coverage being sold to them and establishes oversight to catch fraudulent enrollment patterns. It also requires the government to check if deceased people are still enrolled in plans and terminate those enrollments.

Third, the bill makes major changes to how pharmacy benefit managers—the companies that manage prescription drug benefits for insurance plans—operate. Starting in 2029, these companies face strict rules about what payments they can accept and must provide detailed annual reports showing drug prices, rebates, and costs. The rules are designed to increase transparency and prevent hidden fees that could drive up drug costs for patients and plans.