Health Insurance Premium Fairness Act of 2025

119th Congress Introduced by Julie Johnson and 3 co-sponsors

Allows taxpayers to elect a monthly adjustment that reduces their premium tax credit by Medicare premiums paid by household members, for months after 12/31/2025.

Introduced in House

Purpose

H.R. 6455 seeks to modify the calculation of the health care insurance premium tax credit (as administered under Section 36B of the Internal Revenue Code) by taking into account Medicare premiums paid for household members. The goal is to ensure that Medicare expenses of a taxpayer’s household reduce the premium tax credit, effectively aligning the credit with the total health care costs faced by the household.

Key Provisions

Amendment to Section 36B(b): The bill adds a new paragraph (4) to Section 36B(b) establishing an adjustment to the premium tax credit.

Adjustment Mechanism: For an applicable taxpayer who elects to apply this provision for a coverage month, the amount determined under Section 36B(b)(2)(B)(ii) for that month is reduced by the aggregate amount of specified Medicare premiums paid by the taxpayer’s household members for that month. The reduction cannot reduce the credit below zero.
Household Members Defined: A “household member” is someone who is included in determining the taxpayer’s family size for purposes of the tax credit calculation.
Specified Medicare Premiums: The term covers premiums paid for coverage under Parts A, B, C, or D of title XVIII of the Social Security Act, as well as premiums for a Medicare supplemental policy under section 1882 of the Social Security Act. Importantly, premiums reimbursed by another person are not counted.

Effective Date: The amendments apply to coverage months beginning after December 31, 2025.

Who Is Affected

Taxpayers Claiming the Premium Tax Credit: Individuals and families who are eligible for and elect to apply the premium tax credit for their health insurance coverage.

Household Members: Members of the taxpayer’s household whose Medicare premiums (as defined) would be subtracted from the net premium credit amount.

Medicare Premium Payers: Individuals paying Medicare premiums for Parts A–D and Medicare supplemental policies within the taxpayer’s household.

Procedural and Timeline Details

Introduced: December 4, 2025.

Status: Referred to the House Committee on Ways and Means (introduced in the 119th Congress, 1st Session).

Elective Mechanism: Taxpayers must elect to apply the adjustment for a given coverage month in a manner to be prescribed by the Secretary.

Implementation Window: Applies to coverage months starting after December 31, 2025, meaning the first affected tax years would be those filing for 2026 coverage months.

Impact Overview

The bill would reduce the amount of the premium tax credit for eligible taxpayers by Medicare premium costs incurred by household members, potentially lowering net premium assistance for some families.

It seeks to reflect broader household health care costs within the premium credit calculation, potentially improving fairness from the payer perspective but reducing benefits for those with higher Medicare premiums in their household.

Note: As introduced, the bill is a proposal and has not yet been enacted into law. Further committee action, potential amendments, and floor consideration would determine its final form and effect.

Bill