Health Insurance Premium Fairness Act of 2025
Summary
What This Bill Does
The bill amends Internal Revenue Code section 36B. For a coverage month, an applicable taxpayer may elect to reduce the amount used in the premium tax credit calculation by the aggregate specified Medicare premiums paid by household members, but not below zero. Household members are the individuals counted in family size under section 36B(d)(1). Specified Medicare premiums include unreimbursed premiums paid by the taxpayer or household members for Medicare Parts A, B, C, or D and Medigap policies under Social Security Act section 1882. The rule applies to coverage months beginning after December 31, 2025.
Who Benefits and How
Households that buy exchange coverage while also paying unreimbursed Medicare premiums for family-size members can receive larger premium tax credits because the formula reduces their required contribution. Mixed-coverage families benefit when one household member is on Medicare while another relies on marketplace coverage. Tax preparers and exchange assisters gain a clearer rule for accounting for Medicare premiums in the section 36B calculation.
Who Bears the Burden and How
Federal revenues bear the cost of larger premium tax credits. Treasury and IRS must administer the election, verify unreimbursed Medicare Part A, B, C, D, and Medigap premium amounts, and update forms or instructions. Taxpayers electing the adjustment must document qualifying premiums and household membership.
Key Provisions
- Amends section 36B to reduce the premium tax credit household contribution amount by qualifying Medicare premiums.
- Provides that the adjustment cannot reduce the calculated amount below zero.
- Defines specified Medicare premiums to include unreimbursed Parts A, B, C, D, and Medigap premiums.
- Applies the change to coverage months beginning after December 31, 2025.
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
Changes the Affordable Care Act premium tax credit formula so electing taxpayers can subtract unreimbursed Medicare premiums paid by household members from the household contribution amount for exchange coverage months after December 31, 2025.
Key Policy Areas
Healthcare, Tax, Medicare
Primary Purpose
Changes the Affordable Care Act premium tax credit formula so electing taxpayers can subtract unreimbursed Medicare premiums paid by household members from the household contribution amount for exchange coverage months after December 31, 2025.
Policy Domains
Substantive provisions
Identified Gains
- Households buying exchange coverage
- Medicare household members
- Tax preparers
- Exchange assisters
Identified Costs
- Federal revenues
- Treasury Department
- Internal Revenue Service
- Taxpayers claiming the election
Sponsors
Legislative Progress
In CommitteeMr. Levin (for himself, Ms. Sánchez, Ms. Johnson of Texas, …
Referred to the House Committee on Ways and Means.
Introduced in House
Stakeholder Effects
cui bono?How this legislation distributes effects. Mention counts reflect frequency, not effect magnitude.
Marketplace households paying Medicare premiums, Medicare household members
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