HR6760-119

What This Bill Does

The Protecting Access to Affordable Coverage Act of 2025 changes Affordable Care Act marketplace operations for the 2026 plan year. It requires open enrollment to begin no later than November 1, 2025 and end no earlier than May 1, 2026, giving consumers a longer window to choose qualified health plans. It repeals the section 71303 changes from Public Law 119-21 and restores affected law as if those changes had not been enacted, including the monthly special enrollment pathway for certain low-income marketplace enrollees. The bill also removes a statutory limitation in the premium tax credit rules, requires exchange assister grants to go only to in-state entities, bars enhanced direct enrollment entities and fee-charging enrollment intermediaries from specified assister roles, and dedicates $100 million per year from federal exchange user fees for assister grants.

Who Benefits and How

Low-income ACA marketplace enrollees benefit because the bill restores monthly special enrollment access and preserves easier timing to enter coverage. Marketplace consumers benefit from a longer 2026 open enrollment period. In-state navigator and assister organizations benefit because the bill reserves grant eligibility for entities based in the State they serve and directs $100 million annually from exchange user fees to those grants. State-based coverage assistance programs benefit from clearer federal funding and eligibility rules.

Who Bears the Burden and How

CMS marketplace administrators must modify enrollment calendars, restore preexisting rules, administer the $100 million annual grant allocation, and enforce restrictions on grant recipients. Enhanced direct enrollment entities face a barrier because the bill bars them from the assister grant pathway described in the section. Fee-charging enrollment intermediaries must comply with the same exclusion from specified consumer-assistance roles. Federal exchange user-fee payers bear the cost because the bill dedicates user-fee revenue to grants.

Key Provisions

• Extends ACA marketplace open enrollment for plan year 2026 from no later than November 1, 2025 to no earlier than May 1, 2026.
• Repeals Public Law 119-21 section 71303 changes and restores affected law as if those changes had not been enacted.
• Provides renewed monthly special enrollment access for certain low-income marketplace enrollees.
• Requires exchange assister grants to be awarded only to in-state entities serving that State.
• Bars enhanced direct enrollment entities from specified assister grant roles.
• Restricts fee-charging enrollment intermediaries and dedicates $100 million annually from exchange user fees to assister grants.