Congress quietly expands cheap health plans—but may raise costs for the poor
H.R. 6421 — IMPACT Act of 2025 · Filed by Max Miller (R-OH) · 1 cosponsor · Introduced Dec 4, 2025 · Referred to committee
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What it does
This bill expands who can buy catastrophic health plans under the Affordable Care Act. Currently, catastrophic plans are limited to people under 30 or those with hardship exemptions. The bill adds a new category: people whose household income is too high to qualify for premium tax credits or cost-sharing reductions. This allows higher-income individuals to buy bare-bones, low-premium plans with high deductibles.
Why we flagged it
The bill mechanically expands access to a specific insurance product (catastrophic plans) by loosening an income-based eligibility gate. It is a targeted regulatory amendment, not a broad affordability measure.
What the text implies
- Catastrophic plans have high deductibles and limited coverage; expanding access may shift financial risk from insurers to patients, particularly if higher-income enrollees use these plans as primary coverage rather than emergency-only backup.
- Removal of higher-income enrollees from standard ACA plans reduces the risk pool's income diversity, potentially triggering adverse selection and premium increases for lower-income enrollees who remain in broader plans.
The full analysis lists 4 implications of this text.
Who stands to gain
health insurers (reduced claims from higher-income catastrophic enrollees); higher-income uninsured individuals (access to lower-premium plans)