Bipartisan Health Insurance Affordability Act

Increased Premium Assistance: The bill modifies rules to increase premium assistance amounts for taxpayers with household incomes at or below 150 percent of the poverty line through 2027 (Section 2).

Expanded Tax Credit Eligibility: It extends the ability to receive premium tax credits to taxpayers whose household income exceeds 400 percent of the poverty line, up to 700 percent, for certain years (Section 2).

Fraud Prevention and Consumer Protections: The bill creates a verification process for new enrollments to ensure agent consent and establishes penalties for agents or brokers who provide false or fraudulent information (Section 3).

Protection Against Unauthorized Changes: The Secretary is required to establish a process where individuals are notified of changes to their enrollment or coverage to prevent unauthorized activity (Section 3).

Enhanced Accountability for Pharmacy Benefit Managers: The bill requires pharmacy benefit managers to provide detailed reports on drug costs and transparency regarding pricing guarantees to ensure better oversight (Section 5).

New Health Savings Account Options: Qualified Exchange enrollees will be eligible to establish Health Savings Accounts, providing more ways to manage healthcare costs (Section 7).

Flexible Premium Payment Options: Individuals may have the option to prepay annual premiums or direct a portion of their premium tax credits into a Health Savings Account (Section 8).

Penalties for Agents and Brokers: Agents or brokers may face significant civil penalties, up to $50,000 for negligence or up to $200,000 for knowing violations, and potential criminal penalties including imprisonment (Section 3).

New Verification Requirements: The establishment of a new enrollment verification process and mandatory documentation requirements may create new administrative steps for those using agent-assisted enrollment (Section 3).

Increased Oversight for Marketing Organizations: Field and third-party marketing organizations will face new criteria and regulations regarding how they participate in the enrollment chain (Section 3).