January 23, 2023

**Provisions of the Improving Health Insurance Affordability Act were signed into law through the Inflation Reduction Act & the American Rescue Plan Act** 

**Estimates suggest 8.9 million Americans have lower premiums thanks to enhanced tax credits**

**Shaheen’s efforts mark the most significant update to Affordable Care Act in a decade**

(Washington, DC) – U.S. Senator Jeanne Shaheen (D-NH) today reintroduced her legislation, the Improving Health Insurance Affordability Act. The bill would make permanent enhanced tax credits that led to record Marketplace enrollment, while reducing health care costs for millions of additional Americans.

Last Congress, Shaheen successfully secured premium tax credit enhancement provisions from her legislation through COVID-19 relief legislation, the American Rescue Plan. This expansion of premium tax credits marked the biggest improvement to the Affordable Care Act since it became law over a decade ago. When the tax credits were set to expire at the end of last year, Shaheen successfully extended their authorization through the Inflation Reduction Act. The Improving Health Insurance Affordability Act continues to build on these efforts by making these tax credits permanent while also lowering out-of-pocket costs for Marketplace enrollees. These provisions stand to expand access to health care and lower costs for tens of thousands of Granite Staters and millions of Americans.

“As new COVID variants and viruses like the flu and RSV continue to impact our communities, access to quality, affordable health care continues to be essential. The ACA tax credits authorized by both the American Rescue Plan and Inflation Reduction Act have already made a huge impact for families – substantially lowering costs and increasing access to health insurance. Now, it’s time to make these improvements to the ACA permanent,” said Shaheen. “I’ve been sounding the alarm on the need to pass my legislation to expand and enhance ACA premium tax credits for years, and I hope this Congress we finally take the action needed to ensure health care is within reach for every American.”

The Improving Health Insurance Affordability Act would make permanent the Affordable Care Act’s (ACA’s) enhanced premium tax credits for Health Insurance Marketplace coverage as extended through the Inflation Reduction Act. Those enhanced tax credits increased the value of the tax credits available to people with income between 100 and 400 percent of the federal poverty level (FPL) while expanding eligibility for premium tax credits to include individuals with income above 400 percent of FPL. The bill would also make the second-lowest-cost Gold plan the benchmark plan upon which premium tax credits are based, which would substantially reduce deductible and out-of-pocket costs for families of all incomes. Finally, the bill would also increase the value of cost-sharing reduction (CSR) assistance for people with income between 100 and 250 percent of FPL (who are already eligible), while also expanding eligibility for CSR assistance to people with income up to 400 percent of FPL.

According to the most recent data, nearly 15.9 million Americans have signed up for 2023 individual market health insurance coverage through the Marketplaces since the start of the 2023 Marketplace Open Enrollment. That record-breaking enrollment represents a 13% increase over last year and is driven by the enhanced tax credits first proposed by the Shaheen legislation and ultimately extended through the Inflation Reduction Act. According to a June 2022 report from the Department of Health and Human Services, absent the enhanced tax credits, 8.9 million Americans stood to have their tax credits reduced and 1.5 million would lose their subsidies entirely. Similarly, a February 2021 Urban Institute analysis of changes included in this legislation indicates that this bill could significantly reduce out-of-pocket costs for consumers newly eligible for CSR assistance or heightened levels of CSR assistance through lower deductibles.

In addition to Senator Shaheen, the bill is cosponsored by U.S. Senators Richard Blumenthal (D-CT), Tammy Baldwin (D-WI), Bob Casey (D-PA), Tim Kaine (D-VA), Amy Klobuchar (D-MN), Jack Reed (D-RI), Tina Smith (D-MN), Debbie Stabenow (D-MI), Catherine Cortez Masto (D-NV), Maggie Hassan (D-NH), Ben Cardin (D-MD), Michael Bennet (D-CO) and Kirsten Gillibrand (D-NY).

Full text of the bill is available here.

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