On January 1, 2026, the premium tax credit (PTC) enhancements expired, raising costs for more than 20 million Americans. On January 8, a bipartisan majority in the House of Representatives passed a standalone three-year extension. In the Senate, bipartisan negotiations led by Senator Bernie Moreno (R-OH) have reportedly stalled. On January 28, Senator Moreno released his own draft legislation, the CARE Act.

The CARE Act suggests the negotiating parties may still be far apart. That’s because it combines partial, delayed, and short-term relief with several substantial new PTC reductions that would leave many people worse off than under current law.

In particular, the CARE Act:

• partially restores the enhanced PTC schedule for just one year, 2026. After that, the PTC declines, falling well below enhanced levels in 2027 and below current-law levels for millions of people in 2028, even before the new restrictions proposed by the legislation;
• imposes substantial new PTC restrictions in 2026, 2027, and 2028, leaving millions of people worse off than under current law;
• delays relief getting to consumers by months or more by introducing changes for 2026 that would require new IT builds, rather than restoring the 2025 policy that could be implemented immediately; and
• includes other provisions that would have little impact on affordability.

In short, the CARE Act would reduce the PTC for millions of people in 2026, 2027, and 2028, while denying consumers the immediate help they need for 2026.

This piece examines the CARE Act with a focus on the provisions that affect affordability and coverage.