To provide for a minimum monthly premium payment amount for individuals receiving premium tax credits, and to require additional enrollment verification procedures prior to enrollment in qualified health plans.
Legislative Progress
IntroducedMr. Marshall introduced the following bill; which was read twice …
Summary
What This Bill Does
The ACA Marketplace Integrity Act makes two major changes to the Affordable Care Act (Obamacare) health insurance marketplace. It requires all enrollees receiving premium subsidies to pay at least $5 per month out of pocket, even if their subsidies would otherwise cover the full premium. It also requires all adult enrollees (age 18+) to provide government-issued photo identification when signing up for health insurance through the marketplace.
Who Benefits and How
The federal government benefits through reduced spending on premium subsidies, as enrollees must now pay a minimum $5 monthly premium. Health insurance companies benefit from having all enrollees contribute something toward their premiums, which may reduce adverse selection and improve the risk pool stability. The bill may also reduce fraudulent enrollments by requiring photo ID verification.
Who Bears the Burden and How
Low-income ACA enrollees face new out-of-pocket costs of at least $60 per year ($5/month), even if they previously qualified for zero-premium plans. People without government-issued photo ID - including some homeless individuals, elderly people, and those in rural areas - may face significant barriers to enrolling in health coverage. Undocumented immigrants are effectively barred from enrollment. CMS and state marketplace administrators must implement new ID verification systems.
Key Provisions
- Caps premium tax credits so enrollees must pay at least $5 per month regardless of income
- Requires government-issued photo ID for all adult enrollees (age 18+)
- Gives CMS Administrator authority to require additional documentation for enrollment verification
- Codifies into law a final rule on "Marketplace Integrity and Affordability" (90 Fed. Reg. 27074)
Evidence Chain:
This summary is derived from the structured analysis below. See "Detailed Analysis" for per-title beneficiaries/burden bearers with clause-level evidence links.
Primary Purpose
To require a minimum \ monthly premium payment for ACA marketplace enrollees receiving premium tax credits and to mandate government-issued photo ID verification for enrollment.
Policy Domains
Legislative Strategy
"Reduce federal spending on ACA premium subsidies by requiring minimum enrollee contributions and prevent fraudulent enrollments through stricter ID verification"
Likely Beneficiaries
- Federal government (reduced premium subsidy outlays)
- Health insurance companies (more stable premium collections from required minimum payments)
- Legitimate ACA enrollees (reduced fraud may stabilize marketplace)
Likely Burden Bearers
- Low-income ACA marketplace enrollees (must pay at least \/month even if subsidies would cover full premium)
- Enrollees without government-issued photo ID (may face barriers to enrollment)
- Undocumented immigrants (effectively barred from enrollment due to ID requirements)
- CMS and state marketplace administrators (must implement new verification systems)
Bill Structure & Actor Mappings
Who is "The Secretary" in each section?
- "the_secretary"
- → Secretary of the Treasury
- "the_administrator"
- → Administrator of the Centers for Medicare & Medicaid Services
- "the_administrator"
- → Administrator of the Centers for Medicare & Medicaid Services
Key Definitions
Terms defined in this bill
A health insurance plan certified by a Health Insurance Marketplace that provides essential health benefits
The amount of premium tax credit available to reduce monthly health insurance premiums on the ACA marketplace
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