H.R. 10730 — Healthy Communities Act of 2026

This section extends premium tax credit eligibility under section 36B to taxpayers with household income above 400 percent of the poverty line. It sets the applicable percentage of household income used to calculate the credit at 0 percent for income up to 150 percent of the poverty line, rising on a sliding scale to 8.5 percent for income at 400 percent and higher. It repeals prior restrictions on catastrophic plans and related affordability rules added by Public Law 119–21. The changes apply to taxable years and plan years beginning after December 31, 2025.

This section allows Medicaid coverage gap individuals—those ineligible for Medicaid because their state has not expanded eligibility under section 1902(a)(10)(A)(i)(VIII) of the Social Security Act and whose household income is below 100 percent of the poverty line—to claim premium tax credits under section 36B. Such taxpayers are treated as applicable taxpayers with household income equal to 100 percent of the poverty line and an applicable percentage of zero, effective for taxable years beginning after December 31, 2026.

This section extends the temporary increase in the federal medical assistance percentage (FMAP) for certain Medicaid state plans to 24 quarters (from 8 quarters) and raises the FMAP boost to 10 percentage points (from 5 percentage points). It applies the increase to states that did not expand eligibility to all individuals described in section 1902(a)(10)(A)(i)(VIII) before January 1, 2026, for quarters beginning on or after that date.

This section repeals four health provisions (sections 71107, 71112, 71119, and 71120) from the reconciliation act (Public Law 119–21). It restores prior law for any statutes or regulations addressed in those sections.

This section sets the annual open enrollment period for American Health Benefit Exchanges to end before 2026 under prior regulatory dates, and to run from November 1 of each year through the following January 15 for calendar years beginning with 2026.

This section imposes civil penalties of $10,000 to $50,000 per individual on agents and brokers who negligently provide incorrect information for Exchange enrollments or coverage changes, and civil penalties of up to $200,000 per individual plus criminal penalties of fines under title 18 or up to 10 years imprisonment for knowing and willful violations. It also requires Exchanges operated by the Secretary to verify agent or broker consent and other documentation for new enrollments and coverage changes beginning no later than January 1, 2029, before paying commissions.