Clarifications of Marketplace Coverage and Eligibility Under Public Law 119-21 (H.R. 1) and the 2025 Marketplace Integrity and Affordability Rule

CBO was asked for additional information concerning the ways that Public Law 119-21 (also called H.R. 1 or the 2025 reconciliation act) will affect the ability of certain groups of people to obtain health insurance coverage through the marketplaces established by the Affordable Care Act and the extent to which enrollees are improperly receiving the premium tax credit for that coverage. CBO also was asked for its assessment of the effects of a final rule published by the Department of Health and Human Services in June 2025. That rule takes effect on August 25, 2025.