HOPE Act Temporarily Expands Health Insurance Subsidies to Near-Millionaires, Cracks Down on Agent Fraud

This document is essentially a two-for-one deal: first, a resolution that fast-tracks a vote in the House, and second, the actual bill being voted on—the Bipartisan Healthcare Optimization, Protection, and Extension Act (HOPE Act). The resolution is the procedural muscle, waiving nearly all objections, limiting debate to just one hour, and essentially forcing an immediate up-or-down vote. The HOPE Act itself focuses on two major areas: temporarily expanding who qualifies for subsidized health insurance on the ACA marketplaces and introducing massive new penalties for insurance agents and brokers who mess up enrollments.

The Subsidy Safety Net Gets a Major Upgrade

For most people, the biggest immediate change involves the premium tax credits (subsidies) used to buy health insurance on the ACA Exchange. Right now, if your household income is above 400% of the federal poverty line (FPL)—which is roughly $60,000 for an individual or $125,000 for a family of four—you generally don’t qualify for help. The HOPE Act temporarily blows that cap wide open. For tax years 2026 and 2027, the bill raises the income limit for these tax credits to a staggering 935% of the FPL. To put that in perspective, 935% of the current FPL is close to $140,000 for an individual or nearly $290,000 for a family of four. If you’re a high earner who doesn’t get health insurance through your job, or maybe a small business owner whose income fluctuates, this means you could potentially get significant help covering your premium costs for two years. This section also extends the 2026 open enrollment period to run from November 1, 2025, through May 15, 2026, giving everyone an extra 4.5 months to sign up.

The Hammer Drops on Insurance Agents

While the bill is generous to high-income consumers, it’s brutally strict on the agents and brokers who help people enroll. This is clearly aimed at stopping the bad actors who game the system, but the penalties are steep and affect everyone in the field. For agents or brokers who provide incorrect information due to simple negligence or disregard of the Secretary’s rules, the penalty is a civil fine between $10,000 and $50,000 for each affected individual. If the agent knowingly provides false or fraudulent information, the civil penalty jumps up to $200,000 per affected individual, plus potential criminal charges including up to 10 years in prison. The bill also changes the termination standard for agents working with the federal Exchange, allowing the Secretary to terminate their agreement based on a "preponderance of the evidence"—a lower bar than required in many other legal settings.

New Rules for Enrollment Verification and Marketing

To protect consumers from unauthorized sign-ups, the HOPE Act mandates new consumer protections for agent-assisted enrollments, effective by January 1, 2029. Agents must provide documentation proving they have the individual’s consent for any enrollment or change. If there are inconsistencies, the agent doesn't get paid their commission until the enrollee resolves the issue. Furthermore, the Secretary must establish criteria for states to regulate how marketing organizations (like Field Marketing Organizations or Third-Party Marketing Organizations) operate. These criteria include a requirement that agents act in the best interests of the enrollee (a fiduciary-like standard of conduct) and submit all marketing materials for federal review and approval. Consumers also gain the right to easily access their account information online or via hotline when an agent submits a change.

What This Means for You

If you’re one of the millions of Americans who rely on the ACA marketplace, the HOPE Act is a mixed bag. The Good: If you’re currently paying full price for insurance because your income is just over the 400% FPL threshold, or even far above it, you could see substantial savings in 2026 and 2027. The Caveat: This subsidy expansion is temporary, creating a potential affordability cliff in 2028. The Trade-off: The high penalties on agents might make them more cautious and thorough, which is good for consumers, but it also creates a massive headache for the agents themselves. If agents start leaving the market due to the high liability risk, it could make it harder for people to get personalized enrollment help, particularly for those who aren’t comfortable navigating the online Exchange on their own. Finally, the way this bill is being pushed through—with minimal debate and procedural waivers—means a massive, multi-billion dollar policy change is getting adopted without the usual scrutiny, which should always give taxpayers pause.