Malliotakis Leads Bipartisan Healthcare Legislation to Prevent Healthcare Premium Spikes

(WASHINGTON, DC) - Congresswoman Nicole Malliotakis (R-NY-11) introduced the Bipartisan Health Insurance Affordability Act alongside Reps. Brian Fitzpatrick (R-PA-1), Jared Golden (D-ME-2), Don Bacon (R-NE-2), Tom Suozzi (D-NY-3), Rob Bresnahan (R-PA-8), Don Davis (D-NC-1), and Marie Gluesenkamp Perez (D-WA-3).

The temporary COVID-era Tax Credit is set to expire at the end of 2025, putting millions of Americans who rely on these health plans at risk of higher premiums next year. Members of the Bipartisan Problem Solvers Caucus are working across the aisle to advance solutions that keep health care costs affordable while protecting taxpayers by cracking down on waste, fraud, and abuse.

This legislation extends the Enhanced Premium Tax Credit for two additional years and includes several commonsense reforms. It sets an income cap at 700% of the Federal Poverty Level, which equals to $109,000 for an individual and $225,000 for a family of four. For people using the ACA marketplace who earn less than 150% of the Federal Poverty Level, the legislation would establish a $5 minimum monthly premium, with the option to pay $60 once per year instead. 

The bill includes commonsense antifraud provisions to address waste, fraud, and abuse in the ACA marketplace. In 2024, more than 11.7 million individuals did not use their Affordable Care Act coverage, and an estimated 6.4 million improper enrollments occurred under the Biden era zero-dollar premium policies. The legislation holds insurance brokers criminally accountable for knowingly providing false or fraudulent information and requires regular audits to identify suspicious enrollment patterns and investigate consumer complaints. The legislation also includes a priority from President Trump: an opt-in Health Savings Account, directing 50% of the tax credit directly into the HSA and includes critical PBM reform to rein in middlemen and lower drug prices. 

In New York 11, this legislation would protect the nearly 80,000 people, about 10% who are currently on Affordable Care Act health insurance plans from facing unaffordable spikes in their health insurance premiums. If these credits were allowed to expire, an individual in NY-11 whose income is just above the original Affordable Care Act cutoff would face a 95% increase in their plan premium. By extending these credits, more than 80% of households in NY-11 district will have the option to purchase an Affordable Care Act plan with premium assistance. 

This legislation takes a step in the right direction to end fraudulent behavior by insurance company brokers while ensuring premiums do not spike for middle-class Americans. The Affordable Care Act is not affordable, and action is needed to reform the system to reduce the rising cost of health insurance.

“I join my colleagues to introduce the Bipartisan Health Insurance Affordability Act to protect nearly 80,000 individuals in my district who rely on Affordable Care Act plans from steep premium increases when the temporary premium tax credit subsidy expires at the end of this year,” said Rep. Nicole Malliotakis. “The Affordable Care Act signed into law by President Obama is simply not affordable as premiums have skyrocketed while insurance companies made record profits. Our bipartisan legislation is a balanced, centrist approach to protecting our constituents from steep premium hikes, making Health Savings Accounts more versatile, reducing “Obamacare” fraud and cracking down on insurance companies, insurance brokers, and predatory “Middlemen” Pharmacy Benefit Managers (PBMs).” 

Additional information about the legislation is available HERE.

Bill text is available HERE.