Pub. L. 119–21, title VII, § 71303(b), (c),
(1) by striking “health plan.—The term” and inserting “health plan
“(i) In general
“The term”, and
(2) by adding at the end the following new clause:
“(ii) Pre-enrollment verification process required
“Such term shall not include any plan enrolled in through an Exchange, unless such Exchange provides a process for pre-enrollment verification through which any applicant may, beginning not later than August 1, verify with the Exchange the applicant’s household income and eligibility for enrollment in such plan for plan years beginning in the subsequent year.”
See 2025 Amendment notes below.
Pub. L. 119–21, title VII, § 71303(a), (c),
“(5) Exchange enrollment verification requirement
“(A) In general
“The term ‘coverage month’ shall not include, with respect to any individual covered by a qualified health plan enrolled in through an Exchange, any month beginning before the Exchange verifies, using applicable enrollment information that shall be provided or verified by the applicant, such individual’s eligibility—
“(i) to enroll in the plan through the Exchange, and
“(ii) for any advance payment under section 1412 of the Patient Protection and Affordable Care Act of the credit allowed under this section.
“(B) Applicable enrollment information
“For purposes of subparagraph (A), applicable enrollment information shall include affirmation of at least the following information (to the extent relevant in determining eligibility described in subparagraph (A)):
“(i) Household income and family size.
“(ii) Whether the individual is an eligible alien.
“(iii) Any health coverage status or eligibility for coverage.
“(iv) Place of residence.
“(v) Such other information as may be determined by the Secretary (in consultation with the Secretary of Health and Human Services) as necessary to the verification prescribed under subparagraph (A).
“(C) Verification of past months
“In the case of a month that begins before verification prescribed by subparagraph (A), such month shall be treated as a coverage month if the Exchange verifies for such month (using applicable enrollment information that shall be provided or verified by the applicant) such individual’s eligibility to have so enrolled and for any such advance payment.
“(D) Exchange participation; coordination with other procedures for determining eligibility
“An individual shall not, solely by reason of failing to meet the requirements of this paragraph with respect to a month, be treated for such month as ineligible to enroll in a qualified health plan through an Exchange.
“(E) Waiver for certain special enrollment periods
“The Secretary may waive the application of subparagraph (A) in the case of an individual who enrolls in a qualified health plan through an Exchange for 1 or more months of the taxable year during a special enrollment period provided by the Exchange on the basis of a change in the family size of the individual.
“(F) Information and reliance on third-party sources
“An Exchange shall be permitted to use any data available to the Exchange and any reliable third-party sources in collecting information for verification by the applicant.
“(6) Exchange compliance with filing requirements
“The term ‘coverage month’ shall not include, with respect to any individual covered by a qualified health plan enrolled in through an Exchange, any month for which the Exchange does not meet the requirements of section 155.305(f)(4)(iii) of title 45, Code of Federal Regulations (as published in the Federal Register on
See 2025 Amendment notes below.
Pub. L. 119–21, title VII, § 71301(a), (b), (e),
(1) in paragraph (1), by inserting “or, in the case of aliens who are lawfully present, are not eligible aliens” after “individuals who are not lawfully present”; and
(2) in paragraph (2):
(A) by striking “For purposes of this section, an individual” and inserting “For purposes of this section—
“(A) In general
“An individual”; and
(B) by adding at the end the following new subparagraph:
“(B) Eligible aliens
“An individual who is an alien and lawfully present shall be treated as an eligible alien if such individual is, and is reasonably expected to be for the entire period of enrollment for which the credit under this section is being claimed—
“(i) an alien who is lawfully admitted for permanent residence under the Immigration and Nationality Act (8 U.S.C. 1101 et seq.),
“(ii) an alien who has been granted the status of Cuban and Haitian entrant, as defined in section 501(e) of the Refugee Education Assistance Act of 1980 (Public Law 96–422); or
“(iii) an individual who lawfully resides in the United States in accordance with a Compact of Free Association referred to in section 402(b)(2)(G) of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (8 U.S.C. 1612(b)(2)(G)).”
See 2025 Amendment notes below.
For inflation adjustment of certain items in this section, see Revenue Procedures listed in a table under section 1 of this title.
Sections 1251, 1301, 1302, 1311, 1321, 1402, and 1412 of the Patient Protection and Affordable Care Act, referred to in text, are classified to sections 18011, 18021, 18022, 18031, 18041, 18071, and 18082, respectively, of Title 42, The Public Health and Welfare.
Section 1(c), referred to in subsecs. (b)(3)(B)(ii)(I)(aa) and (f)(2)(B)(i), to be treated, for purposes of the rate of tax, as a reference to the corresponding rate bracket under section 1(j)(2)(C) of this title, see section 1(j)(2)(F) of this title.
Sections 2701 and 2705(d) of the Public Health Service Act, referred to in subsec. (b)(3)(C), are classified to sections 300gg and 300gg–4(d), respectively, of Title 42, The Public Health and Welfare. The reference to section 2705(d) probably should be a reference to section 2705(l), which relates to wellness program demonstration project and is classified to section 300gg–4(l) of Title 42.
Section 1311(d)(2)(B)(ii)(I) of the Patient Protection and Affordable Care Act, referred to in subsec. (b)(3)(E), probably means section 1311(d)(2)(B)(ii) of Pub. L. 111–148, which is classified to section 18031(d)(2)(B)(ii) of Title 42, The Public Health and Welfare, and which does not contain subclauses.
The Social Security Act, referred to in subsec. (c)(1)(B)(ii), is act Aug. 14, 1935, ch. 531, 49 Stat. 620. Title XIX of the Act is classified generally to subchapter XIX (§ 1396 et seq.) of chapter 7 of Title 42, The Public Health and Welfare. For complete classification of this Act to the Code, see section 1305 of Title 42 and Tables.
2025—Subsec. (c)(1)(B). Pub. L. 119–21, § 71302(a), struck out subpar. (B) which related to a special rule for certain individuals lawfully present in the United States for treatment as an applicable taxpayer.
Subsec. (c)(3)(A). Pub. L. 119–21, § 71303(b), designated existing provisions as cl. (i), inserted heading, and added cl. (ii).
Subsec. (c)(3)(A)(iii). Pub. L. 119–21, § 71304(a), added cl. (iii).
Subsec. (c)(5), (6). Pub. L. 119–21, § 71303(a), added pars. (5) and (6).
Subsec. (e)(1). Pub. L. 119–21, § 71301(a), inserted “or, in the case of aliens who are lawfully present, are not eligible aliens” after “individuals who are not lawfully present” in introductory provisions.
Subsec. (e)(2). Pub. L. 119–21, § 71301(b), substituted “For purposes of this section—” for “For purposes of this section,”, designated remainder of existing provisions as subpar. (A), inserted heading, and added subpar. (B).
Subsec. (f)(2). Pub. L. 119–21, § 71305(a), (b)(1), struck out subpar. (A) designation and heading and subpar. (B) which related to limitation on increase of advance payments under section 1412 of the Patient Protection and Affordable Care Actto a taxpayer whose household income is less than 400 percent of the poverty line for the size of the family involved for the taxable year.
2022—Subsec. (b)(3)(A)(iii). Pub. L. 117–169, § 12001(a), substituted “2021 through 2025” for “2021 and 2022” in heading and “after
Subsec. (c)(1)(E). Pub. L. 117–169, § 12001(b), substituted “2021 through 2025” for “2021 and 2022” in heading and “after
2021—Subsec. (b)(3)(A)(iii). Pub. L. 117–2, § 9661(a), added cl. (iii).
Subsec. (c)(1)(E). Pub. L. 117–2, § 9661(b), added subpar. (E).
Subsec. (f)(2)(B)(iii). Pub. L. 117–2, § 9662(a), added cl. (iii).
Subsecs. (g), (h). Pub. L. 117–2, § 9663(a), added subsec. (g) and redesignated former subsec. (g) as (h).
2017—Subsec. (f)(2)(B)(ii)(II). Pub. L. 115–97 substituted “for ‘calendar year 2016’ in subparagraph (A)(ii)” for “for ‘calendar year 1992’ in subparagraph (B)”.
2016—Subsec. (c)(4). Pub. L. 114–255 added par. (4).
2011—Subsec. (c)(2)(D). Pub. L. 112–10 struck out subpar. (D). Prior to amendment, text read as follows: “The term ‘coverage month’ shall not include any month in which such individual has a free choice voucher provided under section 10108 of the Patient Protection and Affordable Care Act.”
Subsec. (d)(2)(B)(iii). Pub. L. 112–56 added cl. (iii).
Subsec. (f)(2)(B)(i). Pub. L. 112–9 amended cl. (i) generally. Prior to amendment, cl. (i) consisted of text and a table limiting increase in amount recovered on reconciliation of health insurance tax credit and advance of that credit for households with income below 500 percent of Federal poverty line.
2010—Subsec. (b)(3)(A)(i). Pub. L. 111–152, § 1001(a)(1)(A), substituted “for any taxable year shall be the percentage such that the applicable percentage for any taxpayer whose household income is within an income tier specified in the following table shall increase, on a sliding scale in a linear manner, from the initial premium percentage to the final premium percentage specified in such table for such income tier:” for “with respect to any taxpayer for any taxable year is equal to 2.8 percent, increased by the number of percentage points (not greater than 7) which bears the same ratio to 7 percentage points as—” in introductory provisions, inserted table, and struck out subcls. (I) and (II) which read as follows:
“(I) the taxpayer’s household income for the taxable year in excess of 100 percent of the poverty line for a family of the size involved, bears to
“(II) an amount equal to 200 percent of the poverty line for a family of the size involved.”
Subsec. (b)(3)(A)(ii). Pub. L. 111–152, § 1001(a)(1)(B), added cl. (ii) and struck out former cl. (ii). Text read as follows: “If a taxpayer’s household income for the taxable year equals or exceeds 100 percent, but not more than 133 percent, of the poverty line for a family of the size involved, the taxpayer’s applicable percentage shall be 2 percent.”
Pub. L. 111–148, § 10105(a), substituted “equals or exceeds” for “is in excess of”.
Subsec. (b)(3)(A)(iii). Pub. L. 111–152, § 1001(a)(1)(B), struck out cl. (iii). Text read as follows: “In the case of taxable years beginning in any calendar year after 2014, the Secretary shall adjust the initial and final applicable percentages under clause (i), and the 2 percent under clause (ii), for the calendar year to reflect the excess of the rate of premium growth between the preceding calendar year and 2013 over the rate of income growth for such period.”
Subsec. (c)(1)(A). Pub. L. 111–148, § 10105(b), inserted “equals or” before “exceeds”.
Subsec. (c)(2)(C)(i)(II). Pub. L. 111–152, § 1001(a)(2)(A), substituted “9.5 percent” for “9.8 percent”.
Subsec. (c)(2)(C)(iv). Pub. L. 111–152, § 1001(a)(2), substituted “9.5 percent” for “9.8 percent” and “(b)(3)(A)(ii)” for “(b)(3)(A)(iii)”.
Pub. L. 111–148, § 10105(c), substituted “subsection (b)(3)(A)(iii)” for “subsection (b)(3)(A)(ii)”.
Subsec. (c)(2)(D). Pub. L. 111–148, § 10108(h)(1), added subpar. (D).
Subsec. (d)(2)(A)(i), (ii). Pub. L. 111–152, § 1004(a)(1)(A), substituted “modified adjusted gross” for “modified gross”.
Subsec. (d)(2)(B). Pub. L. 111–152, § 1004(a)(2)(A), amended subpar. (B) generally. Prior to amendment, text read as follows: “The term ‘modified gross income’ means gross income—
“(i) decreased by the amount of any deduction allowable under paragraph (1), (3), (4), or (10) of section 62(a),
“(ii) increased by the amount of interest received or accrued during the taxable year which is exempt from tax imposed by this chapter, and
“(iii) determined without regard to sections 911, 931, and 933.”
Subsec. (f)(2)(B). Pub. L. 111–309, § 208(a), amended generally subpar. heading and cl. (i). Prior to amendment, text of cl. (i) read as follows: “In the case of an applicable taxpayer whose household income is less than 400 percent of the poverty line for the size of the family involved for the taxable year, the amount of the increase under subparagraph (A) shall in no event exceed $400 ($250 in the case of a taxpayer whose tax is determined under section 1(c) for the taxable year).”
Subsec. (f)(2)(B)(ii). Pub. L. 111–309, § 208(b), inserted “in the table contained” after “each of the dollar amounts” in introductory provisions.
Subsec. (f)(3). Pub. L. 111–152, § 1004(c), added par. (3).
Pub. L. 119–21, title VII, § 71301(e),
Pub. L. 119–21, title VII, § 71302(b),
Pub. L. 119–21, title VII, § 71303(c),
Pub. L. 119–21, title VII, § 71304(b),
Amendment by section 71305 of Pub. L. 119–21, applicable to taxable years beginning after
Pub. L. 117–169, title I, § 12001(c),
Pub. L. 117–2, title IX, § 9661(c),
Pub. L. 117–2, title IX, § 9662(b),
Pub. L. 117–2, title IX, § 9663(b),
Amendment by Pub. L. 115–97 applicable to taxable years beginning after
Pub. L. 114–255, div. C, title XVIII, § 18001(a)(7), “(A) Except as otherwise provided in this paragraph, the amendments made by this subsection [amending this section, sections 106, 4980I, 6051, 6652, and 9831 of this title, and section 18081 of Title 42, The Public Health and Welfare] shall apply to years beginning after “(B) The relief under Treasury Notice 2015–17 shall be treated as applying to any plan year beginning on or before “(C) The amendments made by paragraph (3) [amending this section] shall apply to taxable years beginning after “(D) “(i) The amendments made by paragraph (5) [amending section 6652 of this title] shall apply to notices with respect to years beginning after “(ii) For purposes of section 6652(o) of the Internal Revenue Code of 1986 (as added by this Act), a person shall not be treated as failing to provide a written notice as required by section 9831(d)(4) of such Code if such notice is so provided not later than 90 days after the date of the enactment of this Act [“(E) The amendments made by paragraph (6)(A) [amending section 6051 of this title] shall apply to calendar years beginning after “(F) “(i) The amendments made by paragraph (6)(B) [amending section 18081 of Title 42] shall apply to applications for enrollment made after “(ii) Verification under section 1411 of the Patient Protection and Affordable Care Act [42 U.S.C. 18081] of information provided under section 1411(b)(3)(B) of such Act shall apply with respect to months beginning after October 2016.“(iii) In the case of an application for enrollment under section 1411(b) of the Patient Protection and Affordable Care Act [42 U.S.C. 18081(b)] made before
Pub. L. 112–56, title IV, § 401(b),
Pub. L. 112–10, div. B, title VIII, § 1858(d),
Pub. L. 112–9, § 4(b),
Pub. L. 111–309, title II, § 208(c),
Pub. L. 111–148, title X, § 10108(h)(2),
Pub. L. 111–148, title I, § 1401(e),
Pub. L. 114–255, div. C, title XVIII, § 18001(a)(8),
Pub. L. 112–56, title IV, § 401(c), “(1) The Secretary of the Treasury, or the Secretary’s delegate, shall annually estimate the impact that the amendments made by subsection (a) [amending this section] have on the income and balances of the trust funds established under section 201 of the Social Security Act (42 U.S.C. 401).“(2) If, under paragraph (1), the Secretary of the Treasury or the Secretary’s delegate estimates that such amendments have a negative impact on the income and balances of such trust funds, the Secretary shall transfer, not less frequently than quarterly, from the general fund an amount sufficient so as to ensure that the income and balances of such trust funds are not reduced as a result of such amendments.”