New Act Extends Enhanced ACA Tax Credits Through 2028, Funds Enrollment Help, and Caps Premium Spikes

If you buy your health insurance through the ACA Marketplace (Healthcare.gov or a state exchange), this bill is a big deal. The “Restoring Patient Protections and Affordability Act of 2025” is essentially a major tune-up for the ACA, focusing on making coverage cheaper, easier to get, and more stable. The biggest takeaway: the enhanced premium tax credits—the ones that capped how much of your income you spend on premiums and helped people above the traditional income limits—are extended through 2028. This means the financial relief that many families and small business owners have relied on won't suddenly disappear.

Keeping Coverage Affordable: The Tax Credit Lifeline

Let’s talk money. Title I of this bill extends the enhanced financial assistance that was put in place a few years ago. Before this enhancement, if your income was above 400% of the federal poverty line (FPL), you generally didn't qualify for help. Now, the bill keeps the rule that ensures no one pays more than 8.5% of their household income for a benchmark plan, regardless of where their income falls. For a family of four earning $150,000, this extension through 2028 is the difference between a manageable monthly premium and a budget-busting one. This title also restores $100 million in federal funding for the “Navigator” program in 2026, meaning there will be more free, in-person help available to walk people through plan selection—a huge win for anyone who finds the enrollment process confusing.

Cutting the Red Tape and Surprises

One of the most frustrating parts of health insurance is the paperwork and the surprise bills. Title III and Title IV tackle this head-on. If you’ve ever had your advance premium tax credits revoked because of a bureaucratic error, you know the stress. The bill creates a safety net by establishing a special enrollment period for people who are denied financial assistance during verification, preventing them from losing coverage while the government sorts out the paperwork (Title III). Furthermore, if you received too much in tax credits during the year and owe money back at tax time, Title IV caps that repayment amount, protecting lower-income households from massive, unexpected tax bills.

Insurance companies also get new marching orders. Title II requires insurers to notify enrollees clearly and quickly about changes to their tax credit eligibility and plan changes, with strict 15-day deadlines. If they mess this up, the government can impose financial penalties calculated per affected enrollee, per day. That’s a serious incentive to communicate clearly, which should mean fewer surprise headaches for consumers.

The Automatic Upgrade and Market Stability

There is one provision that could introduce a wrinkle for some folks. Starting in 2026, the exchanges can automatically re-enroll people currently in a lower-cost “bronze” plan into a “silver” plan if the silver plan costs the same or less (Title III). Silver plans usually have better cost-sharing (lower deductibles, co-pays), which is great. However, if you are one of the few who specifically chose a bronze plan because it had the absolute lowest premium and you were willing to take the higher deductible, you need to pay attention during re-enrollment. While the bill aims for a beneficial upgrade, it’s a reminder that “automatic” isn’t always perfect for every budget. You might need to manually select your bronze plan again if that’s your preference.

Title IV also aims to stabilize the market by limiting excessive premium hikes. Starting in 2026, the bill establishes a floor for the annual premium adjustment percentage calculation, using projections tied to employer-sponsored insurance costs. The goal here is to prevent the kind of sudden, sharp annual premium spikes that make budgeting impossible for families. Overall, this legislation is a comprehensive effort to keep the ACA marketplace accessible, affordable, and less prone to administrative pitfalls, making it easier for everyday people to keep their coverage and their peace of mind.