119 S3391 IS: Accountability for Better Care Act of 2025
U.S. Senate
2025-12-09
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II
119th CONGRESS
1st Session
S. 3391
IN THE SENATE OF THE UNITED STATES
December 9, 2025
Mr. Husted introduced the following bill; which was read twice and referred to the Committee on Finance
A BILL
To amend the Internal Revenue Code of 1986 to extend and modify the enhanced premium tax credits, and for other purposes.
1.

Short title
This Act may be cited as the “Accountability for Better Care Act of 2025”.
2.

Extension and modification of credit
(a)

In general
Subparagraph (E) of section 36B(c)(1) of the Internal Revenue Code of 1986 is amended—
(1)
by striking “2025” in the heading and inserting “2027”,
(2)
by striking “January 1, 2026, subparagraph (A)” and inserting “January 1, 2028—
“(i)
except as provided in clause (ii), subparagraph (A)”,
(3)
by striking the period at the end and inserting “, and”, and
(4)
by adding at the end the following new clause:
“(ii)
in the case of such a year beginning after December 31, 2026, subparagraph (A) shall be applied by substituting “600 percent” for “400 percent”.”.
(b)

Applicable percentages
Clause (iii) of section 36B(b)(3)(A) of the Internal Revenue Code of 1986 is amended—
(1)
by striking “2025” in the heading and inserting “2027”,
(2)
by striking “January 1, 2026” and inserting “January 1, 2028”, and
(3)
by striking the last row of the table contained in subclause (II) thereof and inserting the following new rows:
“in the case of taxable years beginning before January 1, 2026, 400.0 percent and higher | 8.5 | 8.5
400.0 percent up to 450.0 percent | 8.5 | 8.5
450.0 percent up to 500.0 percent | 10.5 | 10.5.
500.0 percent up to 550.0 percent | 12.5 | 12.5
550.0 percent up to 600.0 percent | 14.5 | 10.5.
600.0 percent | 16.5 | 16.5.”.
(c)

Minimum monthly payment
Subparagraph (A) of section 36B(b)(3) of the Internal Revenue Code of 1986 is amended by adding at the end the following new clause:
“(iv)

Minimum monthly payment
In the case of taxable years beginning after December 31, 2025, the initial and final premium percentages under clause (iii)(II) shall be adjusted such that in no case is the premium assistance amount greater than an amount equal to the monthly premiums described in paragraph (2)(A) with respect to the taxpayer, reduced by $5.”.
(d)

Rules relating to citizenship
Subsection (e) of section 36B of the Internal Revenue Code of 1986 is amended by adding at the end the following new paragraph:
“(4)

Rules for taxable years after 2025
In the case of a taxable year beginning after December 31, 2025, paragraph (1) shall be applied by substituting “are not citizens of the United States” for “are individuals who are not lawfully present or, in the case of aliens who are lawfully present, are not eligible aliens”.”.
(e)

Rules relating to coverage of abortion
Paragraph (3) of section 36B(c) is amended by adding at the end the following new subparagraph:
“(C)

Rules relating to coverage of abortion
(i)

In general
A plan which provides any benefits or coverage for abortions shall not be treated as a qualified health plan.
(ii)

Exceptions
Clause (i) shall not apply with respect to benefits or coverage of abortions where the life of the mother would be endangered if the fetus were carried to term, or the pregnancy is the result of an act of rape or incest.”.
(f)

Effective date
The amendments made by this section shall apply to taxable years beginning after December 31, 2025.
3.

Rules relating to reduced cost-sharing
(a)

Appropriation
Section 1402 of the Patient Protection and Affordable Care Act (42 U.S.C. 18071) is amended by adding at the end the following new subsection:
“(h)

Funding
There are appropriated, out of any monies in the Treasury not otherwise appropriated, such sums as may be necessary for purposes of making payments under this section for plan years beginning on or after January 1, 2027.”.
(b)

Rules relating to citizenship
Section 1402(e) of the Patient Protection and Affordable Care Act (42 U.S.C. 18071(e)) is amended by adding at the end the following new paragraph:
“(4)

Rules for plan years after 2025
In the case of a plan year beginning after December 31, 2025, paragraph (1) shall be applied by substituting “is not a citizen of the United States” for “is not lawfully present”.”.