ACA Marketplace Bill Cuts Monthly Subsidy by $5 and Adds Mandatory Photo ID for Enrollment

The “ACA Marketplace Integrity Act” is a piece of legislation that targets the Affordable Care Act (ACA) marketplace, specifically focusing on how premium tax credits are calculated and how people verify their identity when signing up for coverage. It’s a short bill, but it packs a few changes that could hit the wallets and the administrative patience of people relying on the Marketplace.

Your Health Subsidy Just Got Five Bucks Lighter

Let’s start with the money. Section 2 of the bill directly amends the Internal Revenue Code (Section 36B) to limit the premium tax credit (PTC) available to Marketplace enrollees. Right now, the amount you get is calculated based on your income and the cost of the benchmark plan. This bill changes the calculation so that the maximum tax credit you can receive is reduced by $5 every single month. This isn’t a massive cut, but it’s real money. If you’re currently receiving a subsidy, your premium will go up by $60 per year starting the month this bill takes effect. For a family already stretching their budget, that’s another co-pay, another tank of gas, or a week’s worth of groceries.

New ID Requirements for Enrollment

Section 3 introduces a new hurdle for people signing up for a Qualified Health Plan (QHP) through the Marketplace. Currently, eligibility verification focuses primarily on income and residency. This bill mandates that when the Exchange verifies eligibility, it must now collect government-issued photo identification for every enrollee over the age of 18. Think about what that means for enrollment. If you’re a young adult who just moved, or maybe someone experiencing homelessness, or an elderly person whose ID has expired and who struggles to get to the DMV, suddenly getting health coverage becomes a lot harder. It’s a classic access barrier.

The Vague Catch-All Documentation Clause

Beyond the photo ID, Section 3 also grants significant new power to the Centers for Medicare & Medicaid Services (CMS) Administrator. The bill states the Exchange must also collect “any other documentation the Administrator... may require for enrollment verification.” This is where things get vague and potentially complicated. While the intent might be to reduce fraud, giving a federal administrator open-ended authority to demand unspecified documentation could lead to burdensome requirements that slow down or prevent eligible people from enrolling. For busy people, having to chase down additional, random paperwork—beyond income verification and photo ID—is a big headache, especially when coverage deadlines are looming.

Locking in a Rule

Finally, Section 4 is the regulatory housekeeping section. It legally enacts a specific 2020 final rule titled “Patient Protection and Affordable Care Act; Marketplace Integrity and Affordability” (published in the Federal Register). When Congress codifies a rule, it essentially takes it out of the hands of future administrations to easily undo. This move locks in specific regulatory policies concerning Marketplace operations and oversight, ensuring those particular integrity and affordability standards are permanent law.