Protecting Health Care and Lowering Costs Act of 2025

Currently, eligible taxpayers may claim the premium tax credit, which applies toward the cost of obtaining health insurance through health insurance exchanges. To qualify, a taxpayer’s household income must meet or exceed 100% of the federal poverty level (FPL) and, after 2025, may not exceed 400% of the FPL (maximum income limit). For 2021-2025, the maximum income limit is eliminated, which generally expands eligibility for the premium tax credit.

Further, under current law, the amount of the premium tax credit is partially based on the taxpayer’s household income multiplied by the applicable percentage. The applicable percentage varies depending on which of six income ranges (adjusted for inflation after 2025) the taxpayer’s household income falls within. For 2021-2025, the applicable percentages are lowered and the adjustment of the applicable percentages for inflation is eliminated, which generally increases the amount of the premium tax credit.

The bill permanently eliminates the 400% maximum income limit, lowers the applicable percentages, and eliminates the inflation adjustment for the applicable percentages.

Finally, the bill repeals multiple Medicaid, Medicare, and health-related tax provisions enacted by the OBBBA, including

certain Medicare and Medicare eligibility and verification requirements,

the reduced window for retroactive Medicaid coverage, and

premium tax credit verification requirements.