399 
under this paragraph shall notify the Sec-
retary of such reductions and the Sec-
retary shall, out of funds made available 
under clause (ii), make periodic and timely 
payments to the issuer equal to 12 percent 
of the total allowed costs of benefits pro-
vided under each such plan to specified en-
rollees during plan years 2026, 2027, and 
2028. 
‘‘(ii) APPROPRIATION.—In addition to 
amounts otherwise available, there are ap-
propriated, out of any money in the Treas-
ury not otherwise appropriated, such sums 
as may be necessary to the Secretary to 
make payments under clause (i). 
‘‘(C) SPECIFIED
ENROLLEE
DEFINED.— 
For purposes of this section, the term ‘specified 
enrollee’ means, with respect to a plan year, an 
eligible insured who is determined at any point 
to have a household income for such plan year 
that does not exceed 138 percent of the poverty 
line for a family of the size involved. Such in-
sured shall be deemed to be a specified enrollee 
for each month in such plan year.’’. 
VerDate Sep 11 2014 
21:44 Feb 02, 2026
Jkt 069200
PO 00000
Frm 00399
Fmt 6652
Sfmt 6201
E:\BILLS\H6900.IH
H6900
ssavage on LAPJG3WLY3PROD with BILLS
400 
(b) OPEN ENROLLMENTS APPLICABLE TO CERTAIN 
LOWER-INCOME POPULATIONS.—Section 1311(c) of the 
Patient Protection and Affordable Care Act (42 U.S.C. 
18031(c)) is amended— 
(1) in paragraph (6)— 
(A) in subparagraph (C), by striking at the 
end ‘‘and’’; 
(B) in subparagraph (D), by striking the 
period at the end and inserting ‘‘; and’’; and 
(C) by adding at the end the following new 
subparagraph: 
‘‘(E) with respect to a qualified health plan 
with respect to which section 1402 applies, for 
months occurring during the period beginning 
on January 1, 2026, and ending on December 
31, 2028, enrollment periods described in sub-
paragraph (A) of paragraph (8) for individuals 
described in subparagraph (B) of such para-
graph.’’; and 
(2) by adding at the end the following new 
paragraph: 
‘‘(8) SPECIAL ENROLLMENT PERIOD FOR CER-
TAIN LOW-INCOME POPULATIONS.— 
‘‘(A) IN GENERAL.—The enrollment period 
described in this paragraph is, in the case of an 
VerDate Sep 11 2014 
21:44 Feb 02, 2026
Jkt 069200
PO 00000
Frm 00400
Fmt 6652
Sfmt 6201
E:\BILLS\H6900.IH
H6900
ssavage on LAPJG3WLY3PROD with BILLS
401 
individual described in subparagraph (B), the 
continuous period beginning on the first day 
that such individual is so described. 
‘‘(B) INDIVIDUAL
DESCRIBED.—For pur-
poses of subparagraph (A), an individual de-
scribed in this subparagraph is an individual— 
‘‘(i) with a household income that 
does not exceed 138 percent of the poverty 
line for a family of the size involved; and 
‘‘(ii) who is not eligible for minimum 
essential coverage (as defined in section 
5000A(f) of the Internal Revenue Code of 
1986), other than for coverage described in 
any of subparagraphs (B) through (E) of 
paragraph (1) of such section.’’. 
(c) ADDITIONAL BENEFITS FOR CERTAIN LOW-IN-
COME INDIVIDUALS FOR PLAN YEARS 2026 AND 2027.— 
Section 1301(a) of the Patient Protection and Affordable 
Care Act (42 U.S.C. 18021(a)) is amended— 
(1) in paragraph (1)— 
(A) in subparagraph (B), by striking 
‘‘and’’ at the end; 
(B) in subparagraph (C)(iv), by striking 
the period and inserting ‘‘; and’’; and 
VerDate Sep 11 2014 
21:44 Feb 02, 2026
Jkt 069200
PO 00000
Frm 00401
Fmt 6652
Sfmt 6201
E:\BILLS\H6900.IH
H6900
ssavage on LAPJG3WLY3PROD with BILLS
402 
(C) by adding at the end the following new 
subparagraph: 
‘‘(D) provides, with respect to a plan of-
fered in the silver level of coverage to which sec-
tion 1402 applies during plan year 2026 and 
2027, for benefits described in paragraph (5) in 
the case of an individual who has a household 
income that does not exceed 138 percent of the 
poverty line for a family of the size involved, 
and who is eligible to receive cost-sharing re-
ductions under section 1402.’’; and 
(2) by adding at the end the following new 
paragraph: 
‘‘(5) ADDITIONAL
BENEFITS
FOR
CERTAIN 
LOW-INCOME INDIVIDUALS FOR PLAN YEAR 2026 AND 
2027.— 
‘‘(A) IN GENERAL.— 
‘‘(i) BENEFITS.—For purposes of 
paragraph (1)(D), the benefits described in 
this paragraph to be provided by a quali-
fied health plan are benefits consisting 
of— 
‘‘(I) 
non-emergency 
medical 
transportation services (as described 
in section 1902(a)(4) of the Social Se-
VerDate Sep 11 2014 
21:44 Feb 02, 2026
Jkt 069200
PO 00000
Frm 00402
Fmt 6652
Sfmt 6201
E:\BILLS\H6900.IH
H6900
ssavage on LAPJG3WLY3PROD with BILLS
403 
curity Act) for which Federal pay-
ments would have been available 
under title XIX of the Social Security 
Act had such services been furnished 
to an individual enrolled under a 
State plan (or waiver of such plan) 
under such title; and 
‘‘(II) services described in sub-
section (a)(4)(C) of section 1905 of 
such Act for which Federal payments 
would have been so available; 
which are not otherwise provided under 
such plan as part of the essential health 
benefits package described in section 
1302(a). 
‘‘(ii) CONDITION
ON
PROVISION
OF 
BENEFITS.—Benefits described in this 
paragraph shall be provided— 
‘‘(I) without any restriction on 
the choice of a qualified provider from 
whom an individual may receive such 
benefits; and 
‘‘(II) without any imposition of 
cost sharing. 
VerDate Sep 11 2014 
21:44 Feb 02, 2026
Jkt 069200
PO 00000
Frm 00403
Fmt 6652
Sfmt 6201
E:\BILLS\H6900.IH
H6900
ssavage on LAPJG3WLY3PROD with BILLS
404 
‘‘(B) PAYMENTS FOR ADDITIONAL BENE-
FITS.— 
‘‘(i) IN
GENERAL.—An issuer of a 
qualified health plan making payments for 
services described in subparagraph (A) fur-
nished to individuals described in para-
graph (1)(D) during plan year 2026 or 
2027 shall notify the Secretary of such 
payments and the Secretary shall, out of 
funds made available under clause (ii), 
make periodic and timely payments to the 
issuer equal to payments for such services 
so furnished. 
‘‘(ii) APPROPRIATION.—In addition to 
amounts otherwise available, there is ap-
propriated, out of any money in the Treas-
ury not otherwise appropriated, such sums 
as may be necessary to the Secretary to 
make payments under clause (i).’’. 
(d) EDUCATION AND OUTREACH ACTIVITIES.— 
(1) IN GENERAL.—Section 1321(c) of the Pa-
tient Protection and Affordable Care Act (42 U.S.C. 
18041(c)) is amended by adding at the end the fol-
lowing new paragraph: 
VerDate Sep 11 2014 
21:44 Feb 02, 2026
Jkt 069200
PO 00000
Frm 00404
Fmt 6652
Sfmt 6201
E:\BILLS\H6900.IH
H6900
ssavage on LAPJG3WLY3PROD with BILLS
405 
‘‘(3) OUTREACH
AND
EDUCATIONAL
ACTIVI-
TIES.— 
‘‘(A) IN GENERAL.—In the case of an Ex-
change established or operated by the Secretary 
within a State pursuant to this subsection, the 
Secretary shall carry out outreach and edu-
cational activities for purposes of informing in-
dividuals 
described 
in 
section 
1902(a)(10)(A)(i)(VIII) of the Social Security 
Act who reside in States that have not ex-
pended amounts under a State plan (or waiver 
of such plan) under title XIX of such Act for 
all such individuals about qualified health plans 
offered through the Exchange, including by in-
forming such individuals of the availability of 
coverage under such plans and financial assist-
ance for coverage under such plans. Such out-
reach and educational activities shall be pro-
vided in a manner that is culturally and linguis-
tically appropriate to the needs of the popu-
lations being served by the Exchange (including 
hard-to-reach populations, such as racial and 
sexual minorities, limited English proficient 
populations, individuals residing in areas where 
the unemployment rates exceeds the national 
VerDate Sep 11 2014 
21:44 Feb 02, 2026
Jkt 069200
PO 00000
Frm 00405
Fmt 6652
Sfmt 6201
E:\BILLS\H6900.IH
H6900
ssavage on LAPJG3WLY3PROD with BILLS
406 
average unemployment rate, individuals in rural 
areas, veterans, and young adults). 
‘‘(B) LIMITATION
ON
USE
OF
FUNDS.— 
Funds appropriated under this paragraph shall 
not be used to promote any health insurance 
coverage other than qualified health plans. 
‘‘(C) FUNDING.—In addition to amounts 
otherwise available, there is appropriated, out of 
any money in the Treasury not otherwise ap-
propriated, to remain available until expended, 
$105,000,000 for fiscal year 2026 to carry out 
this paragraph, of which— 
‘‘(i) $15,000,000 shall be used to 
carry out this paragraph in fiscal year 
2026; and 
‘‘(ii) $30,000,000 shall be used to 
carry out this paragraph for each of fiscal 
years 2027 through 2028.’’. 
(2) NAVIGATOR PROGRAM.—Section 1311(i) of 
the Patient Protection and Affordable Care Act (42 
U.S.C. 18031(i)) is amended— 
(A) in paragraph (1)— 
(i) by striking ‘‘An Exchange’’ and in-
serting the following: 
‘‘(A) IN GENERAL.—An Exchange’’; and 
VerDate Sep 11 2014 
21:44 Feb 02, 2026
Jkt 069200
PO 00000
Frm 00406
Fmt 6652
Sfmt 6201
E:\BILLS\H6900.IH
H6900
ssavage on LAPJG3WLY3PROD with BILLS
407 
(ii) by adding at the end the fol-
lowing: 
‘‘(B) GRANTS
FOR
ELIGIBLE
ENTITIES 
WITH RESPECT TO CERTAIN STATES.—The Sec-
retary shall establish a program to award 
grants to entities described in paragraph (2) to 
carry out the duties described in paragraph (3) 
in one or more States that do not provide under 
the State plan under title XIX of the Social Se-
curity Act (or a waiver of such plan) bench-
mark coverage described in section 1937(b)(1) 
of such Act or benchmark equivalent coverage 
described in section 1937(b)(2) of such Act to 
all 
individuals 
described 
in 
section 
1902(a)(10)(A)(i)(VIII) of such Act.’’; and 
(B) in paragraph (6)— 
(i) by striking ‘‘Grants under’’ and in-
serting the following: ‘‘ 
‘‘(A) STATE EXCHANGES.—Grants under’’; 
and 
(ii) by adding at the end the following 
new subparagraph: 
‘‘(B) FEDERAL
EXCHANGES; GRANTS
TO 
ELIGIBLE ENTITIES WITH RESPECT TO CERTAIN 
STATES.—For purposes of carrying out this 
VerDate Sep 11 2014 
21:44 Feb 02, 2026
Jkt 069200
PO 00000
Frm 00407
Fmt 6652
Sfmt 6201
E:\BILLS\H6900.IH
H6900
ssavage on LAPJG3WLY3PROD with BILLS
408 
subsection, with respect to an Exchange estab-
lished and operated by the Secretary within a 
State pursuant to section 1321(c) and with re-
spect to grants under paragraph (1)(B), the 
Secretary 
shall 
obligate 
not 
less 
than 
$10,000,000 out of amounts collected through 
the user fees on participating health insurance 
issuers pursuant to section 156.50 of title 45, 
Code of Federal Regulations (or any successor 
regulations) for fiscal year 2026, and not less 
than $20,000,000 for each of fiscal years 2027 
and 2028. Such amount so obligated for a fiscal 
year shall remain available until expended.’’. 
(e) FUNDING.—In addition to amounts otherwise 
available, there is appropriated to the Secretary of Health 
and Human Services for fiscal year 2026, out of any 
money in the Treasury not otherwise appropriated, 
$65,000,000, to remain available until expended, for pur-
poses of carrying out the provisions of, and the amend-
ments made by, this section (other than subsections (f) 
and (g)). 
(f) TEMPORARY EXPANSION OF HEALTH INSURANCE 
PREMIUM TAX CREDITS FOR CERTAIN LOW-INCOME POP-
ULATIONS.— 
VerDate Sep 11 2014 
21:44 Feb 02, 2026
Jkt 069200
PO 00000
Frm 00408
Fmt 6652
Sfmt 6201
E:\BILLS\H6900.IH
H6900
ssavage on LAPJG3WLY3PROD with BILLS
409 
(1) IN GENERAL.—Section 36B is amended by 
redesignating subsection (h) as subsection (i) and by 
inserting after subsection (g) the following new sub-
section: 
‘‘(h) CERTAIN TEMPORARY RULES BEGINNING IN 
2026.—With respect to any taxable year beginning after 
December 31, 2025, and before January 1, 2029— 
‘‘(1) ELIGIBILITY
FOR
CREDIT
NOT
LIMITED 
BASED ON INCOME.—Subsection (c)(1)(A) shall be 
applied without regard to ‘equals or exceeds 100 
percent but’. 
‘‘(2) CREDIT ALLOWED TO CERTAIN LOW-IN-
COME
EMPLOYEES
OFFERED
EMPLOYER-PROVIDED 
COVERAGE.—In the case of an individual whose 
household income does not exceed 138 percent of the 
poverty line for a family of the size involved, clause 
(i) of subsection (c)(2)(C) shall be applied (including 
in the case of any individual described in the last 
sentence of such clause) without regard to subclause 
(II) thereof. 
‘‘(3) CREDIT ALLOWED TO CERTAIN LOW-IN-
COME EMPLOYEES OFFERED QUALIFIED SMALL EM-
PLOYER
HEALTH
REIMBURSEMENT
ARRANGE-
MENTS.—A qualified small employer health reim-
bursement arrangement shall not be treated as con-
VerDate Sep 11 2014 
21:44 Feb 02, 2026
Jkt 069200
PO 00000
Frm 00409
Fmt 6652
Sfmt 6201
E:\BILLS\H6900.IH
H6900
ssavage on LAPJG3WLY3PROD with BILLS