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H.R. 6010 makes three main changes to healthcare law and insurance regulations. First, it temporarily reduces the amount of income that uninsured people must contribute toward health insurance premiums for 2026 and 2027, with those earning up to 150 percent of the poverty line paying nothing and those earning higher incomes paying slightly more than current rules allow. Second, it modifies how Medicare Advantage plans receive payments by requiring the use of two years of diagnostic data and excluding diagnoses from certain sources like health risk assessments, while also requiring better evaluation of coding differences between Medicare Advantage and traditional Medicare to prevent overpayments. Third, it cracks down on fraudulent enrollment in health insurance by establishing new civil penalties of $10,000 to $50,000 for insurance agents and brokers who negligently provide false information, up to $200,000 for those who knowingly provide fraudulent information, and criminal penalties including up to 10 years imprisonment for willful fraud. The bill also requires new enrollment verification processes and consumer protections by January 1, 2028, including agent consent documentation, delayed commission payments until information is verified, and clearer notice requirements for consumers.

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