SB46, titled the Health Care Affordability Act of 2025, would amend the Internal Revenue Code to expand eligibility for the Affordable Care Act premium tax credit. Under current law, the refundable credit for coverage purchased through a qualified health plan phases out for households above 400 percent of the federal poverty line; this bill would remove that upper-income cutoff and replace the existing structure with a new sliding-scale schedule that continues eligibility above 400 percent of poverty.
The bill also revises the premium contribution percentages used to calculate the credit. It sets a tiered formula in which lower-income households would generally pay no premium contribution under the credit, while households at higher income levels would face gradually increasing required contributions, topping out at 8.5 percent for those at 400 percent of poverty and above. The changes would apply to taxable years beginning after December 31, 2025.
Impact
If enacted, SB46 would broaden access to federal health insurance subsidies for individuals and families buying coverage on the ACA marketplaces, including middle-income households currently excluded once their income exceeds 400 percent of the poverty line. It would amend section 36B of the Internal Revenue Code, alter the premium tax credit calculation, and make conforming changes to related affordability provisions. The practical effect would be to reduce out-of-pocket premium costs for more enrollees and increase federal spending on refundable premium tax credits.
Sentiment
The bill’s sponsorship by a large group of Senate Democrats suggests strong support among its backers for lowering health insurance costs and expanding marketplace affordability. The available record shows no committee debate, votes, or recorded opposition in the provided materials, so there is no documented floor or committee sentiment beyond the bill’s introduction and referral to the Senate Finance Committee. Overall, the measure is framed as a consumer-affordability and coverage-expansion proposal.
Contention
The main policy issue likely to generate debate is the cost of expanding refundable tax credits to higher-income households, since opponents may view the change as increasing federal spending or extending subsidies beyond the original ACA income cap. Supporters are likely to argue that the current cliff creates affordability gaps for middle-income families and that a smoother sliding scale would make coverage more accessible. Because no transcripts or votes are provided, specific objections or negotiated compromises are not documented in the record supplied here.