Legislative Tracker

Health Care Affordability Act of 2025

This bill makes permanent temporary changes enacted by the American Rescue Plan Act of 2021 (ARPA) and the Inflation Reduction Act of 2022 (IRA) that generally expand eligibility for and increase the amount of the premium tax credit.

Currently, eligible taxpayers may be able to claim the premium tax credit, which applies toward the cost of obtaining health insurance through health insurance exchanges. To be eligible for the premium tax credit, 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 ARPA and IRA eliminated the maximum income limit, which generally expands eligibility for the premium tax credit.

Further, under current law, the amount of the premium tax credit is (1) generally the plan premium (conditions apply), minus (2) the taxpayer’s household income multiplied by the applicable percentage. The applicable percentage is a specific percentage that varies depending on which of six income ranges (adjusted for inflation after 2025) the taxpayer’s household income falls within. For 2021-2025, the ARPA and IRA lowered the applicable percentages and eliminated the adjustment of the applicable percentages for inflation, which generally increases the amount of the premium tax credit.

The bill makes permanent the elimination of the 400% maximum income limit, the lower applicable percentages, and the elimination of the inflation adjustment for the applicable percentages.

Chronic Disease Flexible Coverage Act

This bill provides statutory authority for guidance from the Internal Revenue Service (IRS) that expands the types of preventive care that may be offered under a high deductible health plan (HDHP) without requiring a deductible or with a deductible below the minimum threshold.

Under current law, to be considered health savings account-eligible, an HDHP must have a deductible above a certain minimum threshold amount, which is adjusted annually. However, an HDHP may cover certain types of preventive care without requiring a deductible or with a deductible below the minimum threshold. 

The IRS issued guidance expanding the types of preventive care that may be covered by an HDHP without requiring a deductible or with a deductible below the minimum threshold to include

• angiotensin converting enzyme inhibitors for individuals with congestive heart failure, diabetes, or coronary artery disease;
• anti-resorptive therapy for individuals with osteoporosis or osteopenia;
• beta-blockers for individuals with congestive heart failure or coronary artery disease;
• blood pressure monitors for individuals with hypertension;
• inhaled corticosteroids and peak flow meters for individuals with asthma;
• insulin and other glucose lowering agents, retinopathy screening, glucometers, and hemoglobin A1c testing for individuals with diabetes;
• international normalized ratio testing for individuals with liver disease or bleeding disorders;
• low-density lipoprotein testing for individuals with heart disease;
• statins for individuals with heart disease or diabetes; and
• selective serotonin reuptake inhibitors for individuals with depression. 

The bill provides statutory authority for the IRS's guidance. 

Oral Health Products Inclusion Act

This bill allows individuals to use funds in a flexible spending arrangement (FSA), health reimbursement arrangement (HRA), health savings account (HSA), or Archer medical savings account (Archer MSA) to pay for toothbrushes (manual or electric), water flossers, and oral health products.

Under current law, reimbursements from an FSA or HRA and tax-free distributions from an HSA or Archer MSA may be used to pay for the qualified medical expenses. Reimbursements from an FSA or HRA for nonmedical expenses generally are not allowed and distributions from an HSA or Archer MSA for nonmedical expenses generally are taxed as income and may be subject to an additional penalty.

Under the bill, the definition of qualified medical expenses is expanded to include toothbrushes (manual or electric), water flossers, and oral health products.

The bill defines an oral health product as an over-the-counter product that is (1) used for preventing or treating dental cavities, plaque, or gingivitis; (2) suitable for topical administration to the teeth or gums; and (3) generally recognized as safe and effective. 

Social Security Fairness Act of 2023

This act repeals provisions that reduce Social Security benefits for individuals who receive other benefits, such as a pension from a state or local government.

The act eliminates the government pension offset, which in various instances reduces Social Security benefits for spouses, widows, and widowers who also receive government pensions of their own.

The act also eliminates the windfall elimination provision, which in some instances reduces Social Security benefits for individuals who also receive a pension or disability benefit from an employer that did not withhold Social Security taxes.

These changes are effective for benefits payable after December 2023.