财政部与国税局发布拟议规则 收紧医保保费税收抵免资格与核查
美国财政部与国税局（IRS）10月14日发布拟议规则，落实《工薪家庭减税》（Working Families Tax Cuts）对保费税收抵免（Premium Tax Credit，PTC）的改革。保费税收抵免是一项可退还税收抵免，帮助符合条件的纳税人负担通过健康保险交易所购买的医疗保险费用。财政部表示，此次拟议规则旨在加强资格审查、补上核查环节的缺口，防止该抵免被欺诈和滥用。
根据财政部公布的要点，拟议规则包括：自2027年起，确保纳税人出资的医疗保险补贴只发给依联邦法律符合条件的人；将保费税收抵免的资格限定为美国公民、美国国民及某些合法居留的非公民；对预付保费税收抵免增设新的核查标准。财政部还表示，为落实核查要求而对交易所程序和运作作出的相应调整，预计将由卫生与公众服务部（HHS）依据同一法律的相关条款另行发布配套拟议规则。
财政部长斯科特·贝森特（Scott Bessent）表示：“努力工作的美国纳税人不应被迫为依联邦法律不符合条件的人补贴医疗费用。”他表示，今天的拟议规则落实了《工薪家庭减税》所制定的改革，堵住资格漏洞，确保纳税人出资的保费税收抵免只留给符合条件的美国人。国税局首席执行官弗兰克·J·比西尼亚诺（Frank J. Bisignano）表示：“拟议规则在保护符合条件的纳税人的同时，强化了保费税收抵免的完整性。”
财政部在新闻稿中还提到，医疗保险和医疗补助服务中心（CMS）此前已将超过76万名未经核实的“幽灵”登记人从《平价医疗法案》名册中移除，节省22亿美元；医疗保险和医疗补助服务中心主任梅赫梅特·奥兹（Dr. Mehmet Oz）表示，确保医疗计划只服务符合条件的人，是保护这些计划和纳税人最有效的办法之一。
资料来源：美国财政部2026年10月14日新闻稿。
Treasury and IRS Issue Proposed Rules to Tighten Premium Tax Credit Eligibility and Verification
The U.S. Department of the Treasury and the Internal Revenue Service (IRS) on October 14 issued proposed regulations to implement the Working Families Tax Cuts reforms to the Premium Tax Credit (PTC), a refundable tax credit that helps eligible American taxpayers afford health insurance purchased through the Health Insurance Exchanges. The Treasury Department said the proposed rules strengthen eligibility checks, close gaps in the verification process, and help ensure taxpayer-funded subsidies go only to eligible American taxpayers.
Under the proposed rules, beginning in 2027, taxpayer-funded health insurance subsidies would go only to Americans who qualify under federal law; Premium Tax Credit eligibility would be restricted to U.S. citizens, U.S. nationals, and certain lawfully present noncitizens; and new verification criteria would apply to any advance Premium Tax Credit payments. Treasury said the changes to Exchange procedures and operations needed to implement the verification requirements are expected to be addressed in parallel proposed regulations issued by the Department of Health and Human Services under related provisions of the same statute.
"Hardworking American taxpayers should not be forced to subsidize health care for people who are ineligible under federal law," said Treasury Secretary Scott Bessent, adding that the proposed rules implement the reforms enacted by the Working Families Tax Cuts to close eligibility loopholes. "The proposed rules protect eligible taxpayers while strengthening the integrity of the Premium Tax Credit," said IRS Chief Executive Officer Frank J. Bisignano. "The enhanced verification measures are designed to curb improper claims, ensuring these vital tax benefits go strictly to the hardworking Americans who qualify for them."
The Treasury release also noted that the Centers for Medicare & Medicaid Services (CMS) had removed more than 760,000 unverified "phantom" enrollees from the rolls of the Affordable Care Act, resulting in $2.2 billion in savings. CMS Administrator Dr. Mehmet Oz said ensuring health programs serve only those who are eligible is one of the most effective ways to protect those programs and the taxpayers who support them.
Source: U.S. Department of the Treasury press release, October 14, 2026.
图片来源：图：位于华盛顿特区的美国财政部大楼（资料图）。摄影：Tony Webster，CC BY-SA 3.0，来源：Wikimedia Commons
