HOPE Act Extends Enhanced Health Subsidies Through 2027, Cracking Down Hard on Insurance Enrollment Fraud

The Bipartisan Healthcare Optimization, Protection, and Extension Act—or the HOPE Act—is looking to make health insurance more affordable for the next few years while simultaneously putting the brakes on marketplace fraud. The bill’s main move is extending enhanced premium tax credits for health insurance through 2027, meaning more money stays in your pocket when you pay your monthly premium. Crucially, for 2026 and 2027, the bill also raises the income limit for eligibility way up to 935% of the federal poverty line, opening up subsidies to a much wider range of middle-income families who currently might be priced out of coverage.

Extended Affordability: The Subsidy Lifeline

If you’ve been shopping on the health insurance marketplace, you know those premium tax credits are a game-changer. This bill keeps the better, higher subsidy levels in place for an additional two years (2026 and 2027). For a family of four earning a solid middle-class income, this means they won't suddenly see their monthly premium double or triple when the current enhancements expire. This extension provides critical budget stability for millions of Americans who rely on the marketplace for coverage. It’s a clear win for predictable healthcare costs.

Guardrails Up: Targeting Enrollment Scams

Section 3 of the HOPE Act focuses heavily on fraud prevention, specifically targeting bad actors among agents and brokers who enroll people in plans. This is where the bill gets serious, introducing severe penalties. If an agent or broker is negligent or disregards the rules, they face a civil penalty of $10,000 to $50,000 per affected individual. If they knowingly provide false information, that penalty jumps up to $200,000 per individual, plus potential criminal charges and up to 10 years in prison. This is a massive shift designed to stop the unauthorized enrollments and plan changes that have plagued the Exchanges and frustrated consumers.

To back up these penalties, the bill requires the Secretary of Health and Human Services (HHS) to set up a mandatory verification process for agent-assisted enrollments. Agents must provide proof of consent for any enrollment or plan change. Furthermore, commissions will only be paid after the enrollee resolves any data inconsistencies. This means if an agent enrolls someone without permission or messes up the data, they don't get paid until the consumer confirms everything is correct. This puts the financial incentive squarely on accurate, authorized enrollment.

Regulating the Middlemen and Keeping the Data Clean

Another major change is the new oversight of third-party marketing organizations (TMOs) and field marketing organizations (FMOs)—the companies that often hire and manage the agents and brokers. The Secretary of HHS is now granted authority to regulate these groups, requiring them to register, submit marketing materials for review, and report the termination of any agent. This aims to clean up the often-confusing and sometimes misleading marketing practices that push consumers into suboptimal plans.

On the data front, the bill requires the Secretary to check the Death Master File at least quarterly to identify and remove deceased individuals from active Exchange plans. This seemingly small administrative detail is important for reducing waste and ensuring accurate enrollment figures, which ultimately helps keep costs down for everyone.

More Time to Shop for 2026

Finally, the HOPE Act offers a break for busy consumers by extending the annual open enrollment period for the 2026 plan year. Instead of the usual six weeks, the enrollment window will run from November 1, 2025, until May 15, 2026. This significantly longer period gives people more time to research plans, compare costs, and make informed decisions without the stress of a tight deadline.