IMPACT Act of 2025
Summary
What This Bill Does
The IMPACT Act of 2025 broadens who may buy catastrophic health plans under Affordable Care Act section 1302(e). Current catastrophic-plan access is limited to younger people and people with hardship or affordability exemptions. The bill adds another eligibility route: for the plan year involved, an individual may buy catastrophic coverage if the individual is determined to be ineligible, or reasonably expects to be ineligible, for the section 36B premium tax credit or section 1402 reduced cost-sharing because of household income. The change applies to plan years beginning on or after six months after enactment. The findings frame the bill as a response to health care affordability, rising premiums, and uncompensated care from uninsured patients.
Who Benefits and How
Higher-income consumers who do not qualify for ACA premium tax credits or cost-sharing reductions benefit because they can access lower-premium catastrophic plans. Health insurance issuers benefit from a larger potential catastrophic-plan market. Health care providers may benefit if some currently uninsured people purchase catastrophic coverage, reducing uncompensated care for major medical events. Consumers seeking lower premiums benefit from an additional plan option.
Who Bears the Burden and How
People who choose catastrophic plans bear higher exposure to routine out-of-pocket costs and less first-dollar coverage than richer metal-tier plans. Marketplace administrators and insurers must update eligibility and enrollment rules within six months. ACA marketplace risk pools may face pressure if healthier unsubsidized enrollees move to catastrophic plans. Federal regulators must oversee the new eligibility category tied to income-based ineligibility for subsidies.
Key Provisions
- Amends ACA section 1302(e) to add a new catastrophic-plan eligibility category.
- Allows eligibility when a person is ineligible or reasonably expects to be ineligible for premium tax credits or reduced cost-sharing because of household income.
- Applies the change to plan years beginning on or after six months after enactment.
- Uses findings on affordability, premium stability, and uncompensated care to support the change.
Evidence Chain:
This summary is generated from the full bill text using AI analysis. Expand "Detailed Analysis" below for identified beneficiaries/burden bearers with clause-level evidence links.
At a Glance
What This Bill Does
Expands Affordable Care Act catastrophic-plan eligibility to people who are ineligible or reasonably expect to be ineligible for premium tax credits or reduced cost-sharing because of household income, beginning six months after enactment.
Key Policy Areas
Health Care, Insurance, Tax
Primary Purpose
Expands Affordable Care Act catastrophic-plan eligibility to people who are ineligible or reasonably expect to be ineligible for premium tax credits or reduced cost-sharing because of household income, beginning six months after enactment.
Policy Domains
Substantive provisions
Identified Gains
- Unsubsidized health insurance consumers
- Health insurance issuers
- Health care providers
- Consumers seeking lower premiums
Identified Costs
- Catastrophic plan enrollees
- Marketplace administrators
- ACA marketplace risk pools
- Federal health insurance regulators
Sponsors
Legislative Progress
In CommitteeReferred to the House Committee on Energy and Commerce.
Introduced in House
Mr. Miller of Ohio (for himself and Mr. Smucker) introduced …
Stakeholder Effects
cui bono?How this legislation distributes effects. Mention counts reflect frequency, not effect magnitude.
ACA marketplace risk pools, Health care providers, Health insurance issuers
Positive-direction: Health care providers, Health insurance issuers
Negative-direction: ACA marketplace risk pools
Consumers seeking lower premiums, Unsubsidized health insurance consumers
Bill Structure & Actor Mappings
Who is "The Secretary" in each section?
We use a combination of our own taxonomy and classification in addition to large language models to assess meaning and potential beneficiaries. High confidence means strong textual evidence. Always verify with the original bill text.
Learn more about our methodology