I 
119TH CONGRESS 
2D SESSION 
H. R. 7164 
To expand cost-sharing reductions with respect to qualified health plans 
offered through an Exchange, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
JANUARY 20, 2026 
Ms. SCHRIER (for herself and Ms. BUDZINSKI) introduced the following bill; 
which was referred to the Committee on Energy and Commerce, and in 
addition to the Committee on Ways and Means, for a period to be subse-
quently determined by the Speaker, in each case for consideration of such 
provisions as fall within the jurisdiction of the committee concerned 
A BILL 
To expand cost-sharing reductions with respect to qualified 
health plans offered through an Exchange, and for other 
purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Capping Costs for Con-
sumers Act of 2026’’. 
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SEC. 2. EXPANDING COST-SHARING REDUCTIONS UNDER 
EXCHANGE PLANS. 
(a) IN GENERAL.—Section 1402 of the Patient Pro-
tection and Affordable Care Act (42 U.S.C. 18071) is 
amended— 
(1) in subsection (b)— 
(A) in paragraph (1), by striking ‘‘who en-
rolls’’ and inserting ‘‘subject to the last sen-
tence of this subsection, who enrolls’’; and 
(B) by adding at the end the following sen-
tence: ‘‘With respect to plan years beginning on 
or after January 1, 2028, paragraph (1) shall 
be applied as if the reference to the silver level 
of coverage were a reference to the gold level of 
coverage.’’; 
(2) in subsection (c)(1)(B)(i)— 
(A) in subclause (II), by striking ‘‘an eligi-
ble insured described in paragraph (2)(B)’’ and 
inserting ‘‘, with respect to plan years begin-
ning before January 1, 2028, an eligible in-
sured described in paragraph (2)(B)(i) and, 
with respect to plan years beginning on or after 
January 1, 2028, an eligible insured described 
in paragraph (2)(B)(ii)’’; and 
(B) by amending subclauses (III) and (IV) 
to read as follows: 
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‘‘(III) with respect to plan years 
beginning before January 1, 2028— 
‘‘(aa) 73 percent in the case 
of an eligible insured whose 
household income is more than 
200 percent but not more than 
250 percent of the poverty line 
for a family of the size involved; 
and 
‘‘(bb) 70 percent in the case 
of an eligible insured whose 
household income is more than 
250 percent but not more than 
400 percent of the poverty line 
for a family of the size involved; 
and 
‘‘(IV) with respect to plan years 
beginning on or after January 1, 
2028, 85 percent in the case of an eli-
gible insured described in paragraph 
(2)(C)(ii).’’; 
(3) in subsection (c)(2), by amending subpara-
graphs (B) and (C) to read as follows: 
‘‘(B) in the case of— 
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‘‘(i) with respect to plan years begin-
ning before January 1, 2028, an eligible 
insured whose household income is more 
than 150 percent but not more than 200 
percent of the poverty line for a family of 
the size involved, increase the plan’s share 
of the total allowed costs of benefits pro-
vided under the plan to 87 percent of such 
costs; and 
‘‘(ii) with respect to plan years begin-
ning on or after January 1, 2028, an eligi-
ble insured whose household income is 
more than 150 percent but not more than 
300 percent of the poverty line for a family 
of the size involved, increase the plan’s 
share of the total allowed costs of benefits 
provided under the plan to 87 percent of 
such costs; and 
‘‘(C) in the case of— 
‘‘(i) with respect to plan years begin-
ning before January 1, 2028, an eligible 
insured whose household income is more 
than 200 percent but not more than 250 
percent of the poverty line for a family of 
the size involved, increase the plan’s share 
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of the total allowed costs of benefits pro-
vided under the plan to 73 percent of such 
costs; and 
‘‘(ii) with respect to plan years begin-
ning on or after January 1, 2028, an eligi-
ble insured whose household income is 
more than 300 percent but not more than 
400 percent of the poverty line for a family 
of the size involved, increase the plan’s 
share of the total allowed costs of benefits 
provided under the plan to 85 percent of 
such costs.’’; and 
(4) by adding at the end the following new sub-
section: 
‘‘(h) FUNDING.—Out of any funds in the Treasury 
not otherwise appropriated, there are appropriated to the 
Secretary such sums as may be necessary for payments 
under this section.’’. 
(b) CONFORMING AMENDMENTS TO STATE BASIC 
HEALTH PROGRAMS FOR CERTAIN LOW-INCOME INDIVID-
UALS.—Section 1331(a)(2) of the Patient Protection and 
Affordable Care Act (42 U.S.C. 18051(a)(2)) is amend-
ed— 
(1) in subparagraph (A)(i), by striking ‘‘the ap-
plicable second lowest cost silver plan (as defined in 
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section 36B(b)(3)(B) of the Internal Revenue Code 
of 1986)’’ and inserting ‘‘, with respect to plan years 
beginning before January 1, 2028, the applicable 
second lowest cost silver plan (as defined in section 
36B(b)(3)(B) of the Internal Revenue Code of 1986) 
and, with respect to plans years beginning on or 
after January 1, 2028, the applicable second lowest 
cost gold plan (as defined in such section)’’; and 
(2) in the matter following subparagraph (B), 
by striking ‘‘or the applicable second lowest cost sil-
ver plan’’ and inserting ‘‘or, with respect to plan 
years beginning before January 1, 2028, the applica-
ble second lowest cost silver plan (or, with respect to 
plan years beginning on or after January 1, 2028, 
the applicable second lowest cost gold plan’’. 
SEC. 3. PREMIUM ASSISTANCE CREDIT AMOUNT DETER-
MINED USING APPLICABLE SECOND LOWEST 
COST GOLD PLAN. 
(a) IN GENERAL.—Section 36B of the Internal Rev-
enue Code of 1986 is amended— 
(1) by striking ‘‘silver’’ each place it appears 
and inserting ‘‘gold’’; and 
(2) in the header of subsection (b)(3)(B), by 
striking ‘‘SILVER’’ and inserting ‘‘GOLD’’. 
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(b) EFFECTIVE DATE.—The amendments made by 
this section shall apply to taxable years beginning after 
December 31, 2027. 
Æ 
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