•HRES 902 IH 
any further amendment thereto, to final passage without 
intervening motion except: (1) one hour of debate equally 
divided and controlled by the majority leader and minority 
leader or their respective designees; and (2) one motion 
to recommit. 
SEC. 2. Clause 1(c) of rule XIX and clause 8 of rule 
XX shall not apply to the consideration of H.R. 185. 
SEC. 3. The Clerk shall transmit to the Senate a mes-
sage that the House has passed H.R. 185 no later than 
one calendar day after passage. 
SEC. 4. The amendment in the nature of a substitute 
referred to in the first section of this resolution is as fol-
lows: 
Strike all after the enacting clause and insert 
the following: 
‘‘SECTION 1. SHORT TITLE. 
‘‘This Act may be cited as the ‘Bipartisan Healthcare 
Optimization, Protection, and Extension Act’ or the 
‘HOPE Act’. 
‘‘SEC. 2. EXTENSION AND MODIFICATION OF ENHANCED 
PREMIUM TAX CREDIT. 
‘‘(a) EXTENSION AND MODIFICATION OF RULES TO 
INCREASE
PREMIUM
ASSISTANCE
AMOUNTS.—Section 
36B(b)(3)(A)(iii) of the Internal Revenue Code of 1986 
is amended— 
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‘‘(1) by redesignating subclauses (I) and (II) as 
items (aa) and (bb), respectively, and adjusting the 
margins accordingly, 
‘‘(2) by striking ‘TEMPORARY
PERCENTAGES 
FOR 2021 THROUGH 2025.—In the case of’ and in-
serting ‘TEMPORARY
PERCENTAGES
FOR
CERTAIN 
YEARS.— 
‘‘ ‘(I) BEFORE
2026.—In the 
case of’, and 
‘‘(3) by adding at the end the following: 
‘‘ ‘(II) AFTER 2025.—In the case 
of a taxable year beginning after De-
cember 31, 2025, and before January 
1, 2028— 
‘‘ ‘(aa) clause (ii) shall not 
apply for purposes of adjusting 
premium percentages under this 
subparagraph, and 
‘‘ ‘(bb) the following table 
shall be applied in lieu of the 
table contained in clause (i): 
‘‘In the case of household income (expressed as a 
percent of poverty line) within the following in-
come tier: 
The initial 
premium 
percentage 
is- 
The final 
premium 
percentage 
is- 
Up to 150% 
0.0% 
0.0%
150% up to 200% 
0.0% 
2.0%
200% up to 250% 
2.0% 
4.0%
250% up to 300% 
4.0% 
6.0%
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‘‘In the case of household income (expressed as a 
percent of poverty line) within the following in-
come tier: 
The initial 
premium 
percentage 
is- 
The final 
premium 
percentage 
is- 
300% up to 400% 
6.0% 
8.5%
400% up to 600% 
8.5% 
8.5%
600% up to 800% 
8.5% 
9.0%
800% up to 935% 
9.0% 
9.35%’’. 
‘‘(b) EXTENSION AND MODIFICATION OF RULE TO 
ALLOW CREDIT TO TAXPAYERS WHOSE HOUSEHOLD IN-
COME EXCEEDS 400 PERCENT OF POVERTY LINE.—Sec-
tion 36B(c)(1)(E) of such Code is amended— 
‘‘(1) by striking ‘TEMPORARY RULE FOR 2021 
THROUGH 2025.—In the case of’ and inserting 
‘TEMPORARY RULE FOR CERTAIN YEARS.— 
‘‘ ‘(i) BEFORE 2026.—In the case of’, 
and 
‘‘(2) by adding at the end the following: 
‘‘ ‘(ii) AFTER 2025.—In the case of a 
taxable year beginning after December 31, 
2025, and before January 1, 2028, sub-
paragraph (A) shall be applied by sub-
stituting ‘‘but does not exceed 935 per-
cent’’ for ‘‘but does not exceed 400 per-
cent’’.’. 
‘‘(c) EFFECTIVE DATE.—The amendments made by 
this section shall apply to taxable years beginning after 
December 31, 2025. 
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‘‘SEC. 3. GUARDRAILS TO PREVENT FRAUD IN EXCHANGES. 
‘‘(a) REDUCTION OF FRAUDULENT ENROLLMENT IN 
QUALIFIED HEALTH PLANS.— 
‘‘(1) PENALTIES FOR AGENTS AND BROKERS.— 
Section 1411(h)(1) of the Patient Protection and Af-
fordable Care Act (42 U.S.C. 18081(h)(1)) is 
amended— 
‘‘(A) in subparagraph (A)— 
‘‘(i) by redesignating clause (ii) as 
clause (iv); 
‘‘(ii) in clause (i)— 
‘‘(I) in the matter preceding sub-
clause (I), by striking ‘If—’ and all 
that follows through the ‘such person’ 
in the matter following subclause (II) 
and inserting the following: ‘If any 
person (other than an agent or 
broker) fails to provide correct infor-
mation under subsection (b) and such 
failure is attributable to negligence or 
disregard of any rules or regulations 
of the Secretary, such person’; and 
‘‘(II) in the second sentence, by 
striking ‘For purposes’ and inserting 
the following: 
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‘‘ ‘(iii) DEFINITIONS OF NEGLIGENCE, 
DISREGARD.—For purposes’; 
‘‘(iii) by inserting after clause (i) the 
following: 
‘‘ ‘(ii) CIVIL PENALTIES FOR CERTAIN 
VIOLATIONS BY AGENTS OR BROKERS.—If 
any agent or broker fails to provide correct 
information under subsection (b) or section 
1311(c)(8) or other information, as speci-
fied by the Secretary, and such failure is 
attributable to negligence or disregard of 
any rules or regulations of the Secretary, 
such agent or broker shall be subject, in 
addition to any other penalties that may be 
prescribed by law, including subparagraph 
(C), to a civil penalty of not less than 
$10,000 and not more than $50,000 with 
respect to each individual who is the sub-
ject of an application for which such incor-
rect information is provided.’; and 
‘‘(iv) in clause (iv) (as so redesig-
nated), by inserting ‘or (ii)’ after ‘clause 
(i)’; 
‘‘(B) in subparagraph (B)— 
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‘‘(i) by inserting ‘including subpara-
graph (C),’ after ‘law,’; 
‘‘(ii) by striking ‘Any person’ and in-
serting the following: 
‘‘ ‘(i) IN GENERAL.—Any person’; and 
‘‘(iii) by adding at the end the fol-
lowing: 
‘‘ ‘(ii) CIVIL PENALTIES FOR KNOWING 
VIOLATIONS BY AGENTS OR BROKERS.— 
‘‘ ‘(I) IN
GENERAL.—Any agent 
or broker who knowingly provides 
false or fraudulent information under 
subsection (b) or section 1311(c)(8), 
or other false or fraudulent informa-
tion as part of an application for en-
rollment in a qualified health plan of-
fered through an Exchange, as speci-
fied by the Secretary, shall be subject, 
in addition to any other penalties that 
may be prescribed by law, including 
subparagraph (C), to a civil penalty of 
not more than $200,000 with respect 
to each individual who is the subject 
of an application for which such false 
or fraudulent information is provided. 
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U.S.C. 18031(c)) is amended by adding at the 
end the following new paragraph: 
‘‘ ‘(8) AGENT- OR BROKER-ASSISTED ENROLL-
MENT IN QUALIFIED HEALTH PLANS IN CERTAIN 
EXCHANGES.— 
‘‘ ‘(A) IN GENERAL.—For plan years be-
ginning on or after such date specified by the 
Secretary, but not later than January 1, 2029, 
in the case of an Exchange that the Secretary 
operates pursuant to section 1321(c)(1), the 
Secretary shall establish a verification process 
for new enrollments of individuals in, and 
changes in coverage for individuals under, a 
qualified health plan offered through such Ex-
change, which are submitted by an agent or 
broker in accordance with section 1312(e) and 
for which the agent or broker is eligible to re-
ceive a commission. 
‘‘ ‘(B) REQUIREMENTS.—The enrollment 
verification process under subparagraph (A) 
shall include— 
‘‘ ‘(i) a requirement that the agent or 
broker provide with the new enrollment or 
coverage change such documentation or 
evidence (such as a standardized consent 
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form) or other sources as the Secretary de-
termines necessary to establish that the 
agent or broker has the consent of the in-
dividual for the new enrollment or coverage 
change; 
‘‘ ‘(ii) a requirement that any commis-
sions due to a broker or agent for such 
new enrollment or coverage change are 
paid after the enrollee has resolved all in-
consistencies in accordance with para-
graphs (3) and (4) of section 1411(e); 
‘‘ ‘(iii) a requirement that the infor-
mation required under clause (i) and, as 
applicable, the date on which inconsist-
encies are resolved as described in clause 
(ii), is accessible to the applicable qualified 
health plan through a database or other 
resource, as determined by the Secretary, 
so that any commissions due to a broker or 
agent for such enrollment can be effec-
tuated at the appropriate time; 
‘‘ ‘(iv) a requirement that individuals 
are notified of any changes to enrollment, 
coverage, the agent of record, or premium 
tax credits in a timely manner and that 
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such notice provides plain language in-
structions on how individuals can cancel 
unauthorized activity; 
‘‘ ‘(v) a requirement that individuals 
be able to access their account information 
on a website or other technology platform, 
as defined by the Secretary, when used to 
submit an enrollment or plan change, in 
lieu of the Exchange website described in 
subsection (d)(4)(C), including information 
on the agent of record, the qualified health 
plan, and when any changes are made to 
the agent of record or the qualified health 
plan, on a consumer-facing website or 
through a toll-free telephone hotline; and 
‘‘ ‘(vi) a requirement that the agent or 
broker report to the Secretary any third- 
party marketing organization or field mar-
keting organization (as such terms are de-
fined in section 1312(e)) involved in the 
chain of enrollment (as so defined) with re-
spect to such new enrollment or coverage 
change. 
‘‘ ‘(C) CONSUMER PROTECTION.—The Sec-
retary 
shall 
ensure 
that 
the 
enrollment 
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verification process under subparagraph (A) 
prioritizes continuity of coverage and care for 
individuals, including by not disenrolling indi-
viduals from a qualified health plan without the 
consent of the individual, regardless of whether 
the broker, agent, or qualified health plan is in 
violation of any requirement under this para-
graph.’. 
‘‘(B) 
REQUIRED
REPORTING.—Section 
1311(c)(1) of the Patient Protection and Af-
fordable Care Act (42 U.S.C. 18031(c)(1)) is 
amended— 
‘‘(i) in subparagraph (H), by striking 
‘and’ at the end; 
‘‘(ii) in subparagraph (I), by striking 
the period at the end and inserting ‘; and’; 
and 
‘‘(iii) by adding at the end the fol-
lowing: 
‘‘ ‘(J) report to the Secretary the termi-
nation (as defined in section 1312(e)(1)(C)) of 
an issuer.’. 
‘‘(3) AUTHORITY
TO
REGULATE
FIELD
MAR-
KETING
ORGANIZATIONS
AND
THIRD-PARTY
MAR-
KETING
ORGANIZATIONS.—Section 1312(e) of the 
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Patient Protection and Affordable Care Act (42 
U.S.C. 18032(e)) is amended— 
‘‘(A) by redesignating paragraphs (1) and 
(2) as subclauses (I) and (II), respectively, and 
adjusting the margins accordingly; 
‘‘(B) in subclause (II) (as so redesignated), 
by striking the period at the end and inserting 
‘; and’; 
‘‘(C) by striking the subsection designation 
and heading and all that follows through ‘bro-
kers—’ and inserting the following: 
‘‘ ‘(e) REGULATION OF AGENTS, BROKERS, AND CER-
TAIN MARKETING ORGANIZATIONS.— 
‘‘ ‘(1) AGENTS, BROKERS, AND CERTAIN MAR-
KETING ORGANIZATIONS.— 
‘‘ ‘(A) IN GENERAL.—The Secretary shall 
establish procedures under which a State may 
allow— 
‘‘ ‘(i) agents or brokers—’; and 
‘‘(D) by adding at the end the following: 
‘‘ ‘(ii) field marketing organizations 
and third-party marketing organizations to 
participate in the chain of enrollment for 
an individual with respect to qualified 
health plans offered through an Exchange. 
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‘‘ ‘(B) CRITERIA.—For plan years begin-
ning on or after such date specified by the Sec-
retary, but not later than January 1, 2029, the 
Secretary, by regulation, shall establish criteria 
for States to use in determining whether to 
allow agents and brokers to enroll individuals 
and employers in qualified health plans as de-
scribed in subclause (I) of subparagraph (A)(i) 
and to assist individuals as described in sub-
clause (II) of such subparagraph and field mar-
keting organizations and third-party marketing 
organizations to participate in the chain of en-
rollment as described in subparagraph (A)(ii). 
Such criteria shall, at a minimum, require 
that— 
‘‘ ‘(i) an agent or broker act in accord-
ance with a standard of conduct that in-
cludes a duty of such agent or broker to 
act in the best interests of the enrollee; 
‘‘ ‘(ii) a field marketing organization 
or 
third-party 
marketing 
organization 
agree to report the termination of an agent 
or broker to the applicable State and the 
Secretary, including the reason for termi-
nation; and 
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prospective enrollees in a qualified health 
plan offered through an Exchange. 
‘‘ ‘(iv) MARKETING MATERIALS.—The 
term ‘‘marketing materials’’ means mate-
rials relating to a qualified health plan of-
fered through an Exchange or benefits of-
fered through an Exchange that— 
‘‘ ‘(I) are intended— 
‘‘ ‘(aa) to draw an individ-
ual’s attention to such plan or 
the premium tax credits or cost- 
sharing reductions for such plan 
or plans offered through an Ex-
change; 
‘‘ ‘(bb) to influence an indi-
vidual’s decision-making process 
when selecting a qualified health 
plan in which to enroll; or 
‘‘ ‘(cc) to influence an enroll-
ee’s decision to stay enrolled in 
such plan; and 
‘‘ ‘(II) include or address content 
regarding the benefits, benefit struc-
ture, premiums, or cost sharing of 
such plan. 
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‘‘ ‘(v) TERMINATION.—The term ‘‘ter-
mination’’, with respect to a contract or 
business arrangement between an agent or 
broker and a field marketing organization, 
third-party marketing organization, or 
health insurance issuer, means— 
‘‘ ‘(I) the ending of such contract 
or business arrangement, either uni-
laterally by one of the parties or on 
mutual agreement; or 
‘‘ ‘(II) the expiration of such con-
tract or business arrangement that is 
not replaced by a substantially similar 
agreement. 
‘‘ ‘(vi) THIRD-PARTY MARKETING OR-
GANIZATION.—The term ‘‘third-party mar-
keting organization’’ means an organiza-
tion or individual that is compensated to 
perform lead generation, marketing, or 
sales relating to enrollment of individuals 
in qualified health plans offered through 
an Exchange as part of the chain of enroll-
ment.’. 
‘‘(4) TRANSPARENCY.—Section 1312(e) of the 
Patient Protection and Affordable Care Act (42 
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U.S.C. 18032(e)), as amended by paragraph (3), is 
further amended by adding at the end the following 
new paragraphs: 
‘‘ ‘(2) AUDITS.— 
‘‘ ‘(A) IN GENERAL.—For plan years be-
ginning on or after such date specified by the 
Secretary, but not later than January 1, 2029, 
the Secretary, in coordination with the States 
and in consultation with the National Associa-
tion of Insurance Commissioners, shall imple-
ment a process for the oversight and enforce-
ment of agent and broker compliance with this 
section and other applicable Federal and State 
law (including regulations) that shall include— 
‘‘ ‘(i) periodic audits of agents and 
brokers based on— 
‘‘ ‘(I) complaints filed with the 
Secretary by individuals enrolled by 
such an agent or broker in a qualified 
health plan offered through an Ex-
change; 
‘‘ ‘(II) an incident or enrollment 
pattern that suggests fraud; and 
‘‘ ‘(III) other factors determined 
by the Secretary; and 
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‘‘ ‘(ii) a process under which the Sec-
retary shall share audit results and refer 
potential cases of fraud to the relevant 
State department of insurance. 
‘‘ ‘(B) EFFECT.—Nothing in this para-
graph limits or restricts any referrals made 
under section 1311(i)(3) or any enforcement ac-
tions under section 1411(h). 
‘‘ ‘(3) LIST.—The Secretary shall develop a 
process to regularly provide to qualified health plans, 
Exchanges, and States a list of suspended and ter-
minated agents and brokers.’. 
‘‘(b) REMOVAL OF DECEASED INDIVIDUALS FROM 
EXCHANGE PLANS.—Section 1311(c) of the Patient Pro-
tection and Affordable Care Act (42 U.S.C. 18031(c)), as 
amended by subsection (a), is further amended by adding 
at the end the following new paragraph: 
‘‘ ‘(9) REMOVAL
OF
DECEASED
INDIVIDUALS 
FROM EXCHANGE PLANS.— 
‘‘ ‘(A) IN
GENERAL.—Not later than 90 
days after the date of the enactment of this 
paragraph, and on a quarterly basis thereafter, 
the Secretary shall conduct a check of the 
Death Master File (as such term is defined in 
section 203(d) of the Bipartisan Budget Act of 
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2013) for purposes of identifying individuals 
enrolled in a qualified health plan through an 
Exchange who are deceased. 
‘‘ ‘(B) PROCESS.—The Secretary shall— 
‘‘ ‘(i) establish a process to verify that 
an individual identified pursuant to a 
check described in subparagraph (A) is de-
ceased; and 
‘‘ ‘(ii) require an Exchange to termi-
nate such individual’s enrollment under a 
qualified health plan.’. 
‘‘(c) STANDARD
OF
PROOF
FOR
TERMINATING 
AGENTS AND BROKERS.—Section 1312(e) of the Patient 
Protection and Affordable Care Act (42 U.S.C. 18032(e)), 
as amended by subsection (a), is further amended by add-
ing at the end the following new paragraph: 
‘‘ ‘(4) STANDARD FOR TERMINATION FOR CER-
TAIN
EXCHANGES.—In the case of an agent or 
broker with an agreement in effect with an Ex-
change operated by the Secretary pursuant to sec-
tion 1321(c) to perform activities described in para-
graph (1)(A)(i) with respect to such Exchange, the 
Secretary may terminate such agreement for cause 
if the Secretary finds, based on a preponderance of 
the evidence, that such agent or broker has violated 
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