S. 5619 — Restoring Essential Plan Coverage Act

This section restores eligibility for premium tax credits for health insurance coverage to lawfully present individuals. It reverses all changes made by Section 71301 of Public Law 119–21 and applies the restoration retroactively as if that section had never been enacted.

This section restores eligibility for the premium tax credit under section 36B for lawfully present aliens with household income at or below 100 percent of the poverty line who are ineligible for Medicaid solely due to their immigration status. Such individuals are treated as applicable taxpayers with household income equal to 100 percent of the poverty line. The change applies to taxable years beginning after December 31, 2025.

This section expands eligibility for the Basic Health Program to individuals with household income up to a state-determined percentage between 200 and 250 percent of the poverty line (from 200 percent). The change applies to plan years beginning on or after January 1, 2027.