This bill creates a new Health Freedom Waiver Program that lets States waive specified parts of the Affordable Care Act for plan years starting January 1, 2026, if the State keeps a high‑risk insurance pool or a similar program. Waived ACA parts include two parts of subtitle D, the cost‑sharing reduction rule in section 1402, and certain tax provisions (sections 36B and 5000A of the Internal Revenue Code).
The bill requires the federal government to move the aggregate premium tax credit and cost‑sharing reduction amounts that would have been paid for residents into new "Trump Health Freedom Accounts" (a type of health savings account) for eligible residents of waiver States. The Secretary must calculate payments using a national average silver benchmark premium from States without waivers, and may pay monthly, quarterly, or annually.
States with waivers may operate an Exchange, allow private commercial platforms to sell State‑approved plans, or, if they do neither, the federal government will operate an Exchange for that State. Plans authorized in one waiver State must also be made available on Exchanges or commercial platforms of other waiver States, subject to each State's laws. The bill allows child‑only plans in waiver States. The bill forbids waiving certain consumer protections, including protections for pre‑existing conditions under title XXVII of the Public Health Service Act. Regulators must issue implementing regulations within one year.
The bill also adds Trump Health Freedom Accounts to the tax code as a special kind of health savings account with rules: transfers into the accounts from the waiver program are excluded from HSA deduction limits, only one HSA may be maintained per person (the Trump account), rollovers from existing HSAs are allowed into the Trump account, and amounts in the Trump accounts may not be used to pay for gender transition procedures or abortion services as defined in the bill.
The bill changes the small‑employer tax credit (section 45R) for employers in waiver States: it modifies the credit rate, treats State‑authorized plans as qualified plans, removes the phaseout rules, and alters eligibility and credit period rules.
The bill also directs HHS (with Treasury and Labor) to update guidance and regulations within 90 days to require actual price disclosure, standardize pricing information across hospitals and plans, update enforcement policies for price transparency rules, and require public reporting of providers' outcomes data.
No publicly available information.
No publicly available information.