Skip to content

Kaine, Shaheen, & Colleagues Introduce Bill to Lower Health Care Costs and Expand Access to Health Insurance for Millions of Americans

The Improving Health Insurance Affordability Act would permanently expand enhanced subsidies for Americans with health insurance through the Affordable Care Act, lowering their health care costs

WASHINGTON, D.C. — U.S. Senator Tim Kaine, a member of the Senate Health, Education, Labor, and Pensions (HELP) Committee, joined Senator Jeanne Shaheen (D-NH) and other colleagues in introducing the Improving Health Insurance Affordability Act to lower health care costs and expand access to health insurance for millions of Americans. The American Rescue Plan and Inflation Reduction Act expanded the Affordable Care Act’s enhanced subsidies to help lower health care premiums—provisions Kaine strongly pushed to include. This bill would build on this progress by permanently expanding this support for Americans who purchase health insurance through the Affordable Care Act Marketplace.

“As I travel across Virginia, I often hear about the need to expand access to health care and make coverage more affordable,” said Kaine. “The enhanced subsidies we passed in the American Rescue Plan and Inflation Reduction Act are making a huge difference in helping more Virginians access affordable health care. I’m proud to introduce this legislation to permanently extend this enhanced support and help more Americans get the health care they need and deserve.”

During the pandemic, Congress passed enhanced subsidies to help lower health care premiums for millions of Americans as part of the American Rescue Plan. This support was recently extended through 2025 as part of the Inflation Reduction Act. The expansion of premium subsidies marked the biggest improvement to the Affordable Care Act (ACA) since it became law over a decade ago.

Since Congress expanded support, record numbers of Americans have signed up for health insurance through the ACA. According to the most recent data, nearly 15.9 million Americans have signed up for health insurance coverage through Affordable Care Act Marketplaces since the start of the 2023 Marketplace Open Enrollment, representing a 13% increase over last year. According to a June 2022 report from the Department of Health and Human Services, absent the enhanced subsidies, 8.9 million Americans stood to have their subsidies reduced and 1.5 million would lose their subsidies entirely. Similarly, a February 2021 Urban Institute analysis of this legislation indicates that this bill could significantly reduce out-of-pocket costs for consumers.

Specifically, the Improving Health Insurance Affordability Act would:

  • Make permanent the enhanced subsidies for Affordable Care Act Health Insurance Marketplace coverage, which were extended through 2025 in the Inflation Reduction Act. Those enhanced subsidies increased the value of the subsidies available to people with income between 100 and 400 percent of the federal poverty level (FPL) while expanding eligibility for premium tax credits to include individuals with income above 400 percent of FPL.
  • Make the second-lowest-cost Gold plan the benchmark plan upon which premium subsidies are based, which would substantially reduce deductible and out-of-pocket costs for families of all incomes.
  • Increase the value of cost-sharing reduction (CSR) assistance for people with income between 100 and 250 percent of FPL (who are already eligible), while also expanding eligibility for CSR assistance to people with income up to 400 percent of FPL.

Kaine has long led efforts to expand health care. He has introduced legislation to lower health care costs by creating a low-cost public health insurance option available to all Americans. An Urban Institute report found that his bill would reduce the uninsured population by over a million Americans and save households, employers, and the government billions of dollars.

In addition to Kaine and Shaheen, the bill is cosponsored by U.S. Senators Richard Blumenthal (D-CT), Tammy Baldwin (D-WI), Bob Casey (D-PA), Amy Klobuchar (D-MN), Jack Reed (D-RI), Tina Smith (D-MN), Debbie Stabenow (D-MI), Catherine Cortez Masto (D-NV), Maggie Hassan (D-NH), Ben Cardin (D-MD), Michael Bennet (D-CO) and Kirsten Gillibrand (D-NY).

Full text of the bill is available here.