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Congress·In Committee·H.R. 7861

Care Over Profits Act of 2026

Rep. Barrett Introduces Care Over Profits Act to Raise Insurance Payouts and Curb Fraud

17 days ago·View on Congress.gov·Read full text

The Care Over Profits Act of 2026 is currently in the early stages of the legislative process after being referred to the House Committee on Energy and Commerce. It is considered actively moving as it awaits further review and potential hearings by the committee. There are no upcoming votes scheduled at this time.

Legislative Progress

House
Senate
President
Law

Key Points

  • The bill raises the medical loss ratio (MLR) for individual and small group health insurance markets from 80% to 85%, meaning insurers must spend a larger share of premiums on actual medical care and quality improvements rather than administrative costs and profits.

    From policy text

    “Section 2718(b)(1)(A)(ii) of the Public Health Service Act (42 U.S.C. 300gg-18(b)(1)(A)(ii)) is amended by striking ``80'' each place it appears and inserting ``85''.”
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  • If insurers fail to meet the new 85% threshold, they must issue rebates to their customers, just as they do under current law when they miss the 80% mark. This change means more premium dollars going toward doctors, treatments, and health services.
  • The bill creates new civil penalties for insurance agents and brokers who negligently provide incorrect information on health plan enrollment applications, with fines ranging from $10,000 to $50,000 per affected individual.

    From policy text

    “such agent or broker shall be subject, in addition to any other penalties that may be prescribed by law, including subparagraph (C), to a civil penalty of not less than $10,000 and not more than $50,000 with respect to each individual who is the subject of an application for which such incorrect information is provided.”
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  • Agents or brokers who knowingly and willfully commit fraud on health plan applications face up to $200,000 in civil fines per affected person, and criminal penalties including up to 10 years in prison.

    From policy text

    “Any agent or broker who knowingly and willfully provides false or fraudulent information under subsection (b), or other false or fraudulent information as part of an application for enrollment in a qualified health plan offered through an Exchange, as specified by the Secretary, shall be fined under title 18, United States Code, imprisoned for not more than 10 years, or both.”
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  • The higher MLR requirement takes effect for plan years starting on or after January 1, 2026, while the new agent and broker penalties kick in for the 2027 plan year.

    From policy text

    “The amendments made by this section shall apply with respect to plan years beginning on or after January 1, 2026.”
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Healthcare

Impact Analysis

Personal Impact

Scores: 1 = low, 5 = highSentiment: -5 to +5 (net benefit)

Milestones

2 milestones2 actions
Mar 9, 2026House

Referred to the House Committee on Energy and Commerce.

Mar 9, 2026

Introduced in House

Source Information

Document Type

Congressional Bill

Official Title

Care Over Profits Act of 2026

Bill NumberHR 7861
Congress119th Congress
ChamberHouse of Representatives
Latest ActionReferred to the House Committee on Energy and Commerce.
Read Full Bill Text

Sponsor

Cosponsors

(1)
D: 1

Analysis generated by AI. Always verify with official sources.