Care Over Profits Act of 2026

This bill, known as the Care Over Profits Act of 2026, aims to reform health insurance regulations by increasing the minimum medical loss ratio requirement and strengthening penalties for fraudulent enrollment practices. It directly affects health insurance companies offering plans in small group and individual markets, as well as agents and brokers who help people enroll in qualified health plans through health insurance exchanges. The bill raises the medical loss ratio requirement from 80% to 85% starting in 2026, meaning insurers must spend at least 85 cents of every premium dollar on medical care rather than administrative costs or profits. Additionally, it introduces new civil and criminal penalties for agents and brokers who negligently or knowingly provide false information during enrollment applications, with fines ranging from $10,000 to $200,000 per affected individual and potential imprisonment of up to 10 years for willful violations.