Health Care Improvement Act of 2021. HCIA-21 has several moving parts that seem to mostly conform to median Democratic positions and policy preferences. One of the big ones is removing the income cap for subsidy eligibility and also enriching the premium tax credits. Capping health care costs on the ACA exchanges: The Health Care Improvement Act of 2021 will ensure no individual or family pays more than 8.5 percent of their total household income for their health insurance. Currently, no family making more than 400 percent of the federal poverty line ($51,040 for an individual in 2020) is eligible for premium assistance on the ACA exchanges. This provision – which is supported in President Biden’s American Rescue Plan – expands premium assistance to individuals making more than 400 percent of the federal poverty line and places a cap on insurance costs for all individuals and families on the ACA exchanges.