PlainBillCongress, translated.Legislation. Context. Public interest.Referred to the Committee on Energy and Commerce, and in addition to the Committees on Ways and Means, Education and Workforce, the Judiciary, Armed Services, Veterans' Affairs, Foreign Affairs, and Financial Services, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Congressional Research Service
No official summary is available in the imported record yet.
People & committees
Rep. Burlison, Eric [R-MO-7] · R–MO
Legislative record
A procedural vote is different from passage. Passage in one chamber does not establish enactment. Explore the glossary.
Referred to the Committee on Energy and Commerce, and in addition to the Committees on Ways and Means, Education and Workforce, the Judiciary, Armed Services, Veterans' Affairs, Foreign Affairs, and Financial Services, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Referred to the Committee on Energy and Commerce, and in addition to the Committees on Ways and Means, Education and Workforce, the Judiciary, Armed Services, Veterans' Affairs, Foreign Affairs, and Financial Services, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Referred to the Committee on Energy and Commerce, and in addition to the Committees on Ways and Means, Education and Workforce, the Judiciary, Armed Services, Veterans' Affairs, Foreign Affairs, and Financial Services, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Referred to the Committee on Energy and Commerce, and in addition to the Committees on Ways and Means, Education and Workforce, the Judiciary, Armed Services, Veterans' Affairs, Foreign Affairs, and Financial Services, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Referred to the Committee on Energy and Commerce, and in addition to the Committees on Ways and Means, Education and Workforce, the Judiciary, Armed Services, Veterans' Affairs, Foreign Affairs, and Financial Services, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Referred to the Committee on Energy and Commerce, and in addition to the Committees on Ways and Means, Education and Workforce, the Judiciary, Armed Services, Veterans' Affairs, Foreign Affairs, and Financial Services, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Referred to the Committee on Energy and Commerce, and in addition to the Committees on Ways and Means, Education and Workforce, the Judiciary, Armed Services, Veterans' Affairs, Foreign Affairs, and Financial Services, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Referred to the Committee on Energy and Commerce, and in addition to the Committees on Ways and Means, Education and Workforce, the Judiciary, Armed Services, Veterans' Affairs, Foreign Affairs, and Financial Services, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Introduced in House
Introduced in House
Primary sources
Text links open the official source. We also preserved the text version used in the PlainBill explanation below.
No related bills are listed in this snapshot. This does not establish whether the proposal has appeared in earlier Congresses.
Source last updated: Aug 11, 2026. Consult Congress.gov for the current record.
AI Conversation Starters
Choose a perspective, copy a prompt, and paste it into your preferred AI. Each prompt includes the bill version and available official source links, and asks for counterarguments as well as supporting evidence.
Analyze H.R.10015 as objectively as possible. Explain its main provisions, who would be affected, possible benefits and harms, implementation, exceptions, and uncertainties. Present the strongest arguments for and against it, and identify evidence needed to assess its public impact.
Examine H.R.10015 through a progressive lens, focusing on fairness, access, economic inequality, and effects on vulnerable communities. Explain potential benefits, costs, and unintended consequences. Consider the strongest counterarguments and distinguish stated goals from demonstrated outcomes.
Examine H.R.10015 through a conservative lens, focusing on fiscal responsibility, institutional stability, federalism, and the scope of government. Explain potential benefits, costs, and unintended consequences. Consider the strongest counterarguments and any provisions that challenge this perspective.
Examine H.R.10015 through a civil-liberties and limited-government lens. Consider individual rights, privacy, voluntary choice, accountability, and government power. Explain tradeoffs, possible safeguards, and the strongest counterarguments without assuming the proposal is beneficial or harmful.
PlainBill explanation
Based on the full Introduced in House · 2026-08-03 text. This explanation has not received human editorial review. This overview describes the proposal’s major provisions; it does not establish what its real-world effects would be.
This proposal would revise health savings account contribution limits, add qualifying food, supplements, and fitness expenses to permitted medical spending, and let qualifying membership pools offer group health coverage. It would require more public health care prices, clearer patient bills, and greater health plan access to payment information. It also would change rebates for certain negotiated-price drugs, allow designated health professionals to dispense selected drugs after patient assessments, and require related coverage in government-sponsored programs. Separately, section 601 would repeal a cited Federal Reserve provision and cap earnings on specified supplemental reserves at the Federal Reserve securities portfolio's previous-quarter rate, subject to a referenced exception. The repealed provision is not reproduced, so its full effect is not established here.
an amount equal to the applicable dollar amount under paragraph (1)(B) of section 402(g) (as adjusted pursuant to paragraph (4) of such section) with respect to such taxable year.
amounts paid for qualified wellness expenses shall be treated as paid for medical care
the term qualified wellness expenses means amounts paid for healthy food, vitamins, dietary supplements (as defined in section 201(ff) of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 321(ff))), or qualified sports and fitness expenses.
An entity (referred to in this section as a health marketplace pool) that meets the requirements under subsection (b) shall be deemed an employer under section 3(5) for purposes of offering a group health plan or group health insurance coverage
on a monthly basis compile and make public (without subscription and free of charge)
shall include with such request a written, itemized bill of the cost of each reasonably expected item or service the health care provider or health care facility provided to the individual
allows the responsible plan fiduciary (as that term is defined in subparagraph (B)(ii)(I)(ee)) access to all claims and encounter information or data, and any documentation supporting claim payments
the manufacturer of a selected drug shall, for such drug, not later than 30 days after the date of receipt from the Secretary of the information described in subparagraph (A) for such calendar quarter, provide to the Secretary a rebate
an expanded-access prescription drug may be dispensed and administered by a covered individual after conducting an appropriate patient assessment consistent with protocols to be issued by the Secretary.
The President shall take such steps as are necessary to ensure that each Government sponsored program includes coverage for expanded-access prescription drugs administered by covered individuals to beneficiaries of the program.
Paragraph (12) of section 19(b) of the Federal Reserve Act (12 U.S.C. 461(b)) is hereby repealed.
The supplemental reserve authorized under subparagraph (A) shall be maintained by the Federal Reserve banks in an Earnings Participation Account. Except as provided in subsection (c)(1)(A)(ii), such Earnings Participation Account shall receive earnings to be paid by the Federal Reserve banks during each calendar quarter at a rate not more than the rate earned on the securities portfolio of the Federal Reserve System during the previous calendar quarter.
Section 102 would tie the annual health savings account contribution limit to an inflation-adjusted dollar limit specified elsewhere in the tax code. People who reach age 50 before year-end would receive an additional allowance tied to another indexed tax-code limit. These changes would apply to tax years beginning after enactment; the supplied text does not state the resulting dollar amounts.
an amount equal to the applicable dollar amount under paragraph (1)(B) of section 402(g) (as adjusted pursuant to paragraph (4) of such section) with respect to such taxable year.
In the case of an individual who has attained age 50 before the close of the taxable year, the amount of the limitation under paragraph (1) shall be increased by an amount equal to the applicable dollar amount under subparagraph (B)(i) of section 414(v)(2) (as adjusted pursuant to subparagraph (C) of such section).
The amendments made by this section shall apply to taxable years beginning after the date of the enactment of this Act.
Section 103 would rewrite the health savings account deduction to cover cash contributions by or for an individual, remove specified eligibility language, and replace one employer-plan reference to high-deductible coverage with a reference to any employee who has an account. To meet the revised employer-contribution requirements, employers would have to make comparable contributions available to comparable participating employees, with separate treatment for part-time workers and proportional treatment for part-year workers. This does not establish an unconditional requirement for every employer to fund accounts. The changes would apply to tax years beginning after enactment.
In the case of an individual, there shall be allowed as a deduction for the taxable year an amount equal to the aggregate amount paid in cash during such taxable year by or on behalf of such individual to a health savings account of such individual.
by striking who is an eligible individual (as defined in section 223(c)(1))
by striking to any eligible individual covered under a high deductible health plan of the employer in paragraph (4)(B)(ii) (as so redesignated) and inserting to any employee with respect to whom a health savings account has been established.
An employer meets the requirements of this subsection for any calendar year if the employer makes available comparable contributions to the health savings accounts of all comparable participating employees for each coverage period during such calendar year.
the term comparable contributions means contributions— (i) which are the same amount, or (ii) if the employees are covered by a health plan, which are the same percentage of the annual deductible limit under the plan covering the employees.
a contribution to the health savings account of such employee shall be treated as comparable if it is an amount which bears the same ratio to the comparable amount (determined without regard to this subparagraph) as such portion bears to the entire calendar year.
Paragraph (3) shall be applied separately with respect to part-time employees and other employees.
The amendments made by this section shall apply to taxable years beginning after the date of the enactment of this Act.
Section 104 would add primary care arrangements involving a fixed periodic fee or payment for primary care services to the health savings account medical-expense language. It would extend the relevant family-expense language to an account holder's children who have not reached age 27 by year-end. It would also delete two existing subparagraphs, whose contents are not supplied. The substantive changes would cover amounts paid after enactment in tax years beginning after enactment.
by inserting or pursuant to an arrangement under which an individual is provided coverage restricted to primary care services in exchange for a fixed periodic fee or payment for primary care services after menstrual care products
by striking subparagraphs (B) and (C)
and any child (as defined in section 152(f)(1)) of such individual who has not attained the age of 27 before the end of such individual’s taxable year.
The amendments made by subsections (a) and (b) shall apply with respect to amounts paid after the date of the enactment of this Act in taxable years beginning after such date.
Section 105 would allow otherwise qualifying medical expenses incurred before an account was opened to qualify if incurred in the account-opening tax year. Prior-year expenses could also qualify if the account was opened before that year's tax-return filing deadline, excluding extensions. This would apply to tax years beginning after enactment.
An expense shall not fail to be treated as a qualified medical expense solely because such expense was incurred before the establishment of the health savings account if such expense was incurred— (i) during either— (I) the taxable year in which the health savings account was established, or (II) the preceding taxable year, in the case of a health savings account established after the taxable year in which such expense was incurred but before the time prescribed by law for filing the return for such taxable year (not including extensions thereof), and (ii) for medical care which (but for the fact that it was incurred before the establishment of the account) otherwise meets the requirements of the preceding subparagraphs.
The amendment made by this section shall apply to taxable years beginning after the date of the enactment of this Act.
Effective on enactment, section 106 would create an exception to a referenced account-distribution rule for corrections of administrative, clerical, or payroll contribution errors. The person must receive the correction and attributable earnings by the tax-return deadline, including extensions. Those earnings would count as income in the year received; the underlying distribution rule is not reproduced.
Subparagraph (A) shall not apply if any payment or distribution is made to correct an administrative, clerical, or payroll contribution error and if— (i) such distribution is received by the individual on or before the last day prescribed by law (including extensions of time) for filing such individual’s return for such taxable year, and (ii) such distribution is accompanied by the amount of net income attributable to such contribution. Any net income described in clause (ii) shall be included in the gross income of the individual for the taxable year in which it is received.
The amendment made by this section shall take effect on the date of the enactment of this Act.
Section 107 would extend existing surviving-spouse account language to a child, parent, or grandparent. Under its added child-specific sentence, the account would be treated as the child's own health savings account when the child acquires the beneficiary's interest and the specified section 151 deduction is allowable to another taxpayer for the stated tax year. These changes would apply to tax years beginning after enactment; the complete existing inheritance rule is not reproduced.
by inserting , child, parent, or grandparent after surviving spouse
In the case of a child who acquires such beneficiary’s interest and with respect to whom a deduction under section 151 is allowable to another taxpayer for a taxable year beginning in the calendar year in which such individual’s taxable year begins, such health savings account shall be treated as a health savings account of such child.
The amendments made by this section shall apply to taxable years beginning after the date of the enactment of this Act.
Section 108 would let qualifying healthy food, vitamins, dietary supplements, and fitness expenses count as medical care for health savings accounts. Monthly limits per covered individual would be $100 for account balances up to $5,000, $150 for balances above $5,000 through $10,000, and $200 above $10,000. Fitness facilities would have to meet specified conditions, excluding member-owned private clubs and facilities offering golf, hunting, sailing, or riding. Equipment must be used exclusively for physical activity; clothing and footwear must be necessary for, and used only for, a specific activity. The changes would apply to tax years beginning after enactment.
amounts paid for qualified wellness expenses shall be treated as paid for medical care, but only to the extent that such amounts paid with respect to each individual described in the first sentence of this subparagraph do not exceed $100 per month in the case of a health savings account the balance of which does not exceed $5,000; $150 per month in the case of a health savings account the balance of which exceeds $5,000 but does not exceed $10,000; and $200 per month in the case of a health savings account the balance of which exceeds $10,000.
the term qualified wellness expenses means amounts paid for healthy food, vitamins, dietary supplements (as defined in section 201(ff) of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 321(ff))), or qualified sports and fitness expenses.
(bb) which is not a private club owned and operated by its members, (cc) which does not offer golf, hunting, sailing, or riding facilities, (dd) the health or fitness component of which is not incidental to its overall function and purpose, and (ee) which is fully compliant with the State of jurisdiction and Federal anti-discrimination laws.
(aa) if such equipment is utilized exclusively for participation in fitness, exercise, sport, or other physical activity, and (bb) in the case of amounts paid for apparel or footwear, if such apparel or footwear is of a type that is necessary for, and is not used for any purpose other than, a specific physical activity.
The amendments made by this section shall apply to taxable years beginning after the date of the enactment of this Act.
Section 109 would give health savings accounts the same treatment as individual retirement accounts under the cited bankruptcy exemption section. It would apply to bankruptcy cases begun after enactment. The text does not reproduce the underlying exemption limits.
For purposes of this section, any health savings account (as described in section 223 of the Internal Revenue Code of 1986) shall be treated in the same manner as an individual retirement account described in section 408 of such Code.
The amendment made by this section shall apply to cases commencing under title 11, United States Code, after the date of the enactment of this Act.
Section 110 would treat an employer's offer of $450 a month to an employee's health savings account as an offer of qualifying employer coverage for the employer-mandate provision, with the specified affordability treatment. When an employer contributes at least $450 monthly, the employer-contribution income exclusion would apply only if the employee has health care coverage that month. These changes would apply to months in tax years beginning after enactment.
An offer to make a contribution of $450 per month to an employee’s health savings account shall be treated for purposes of this section as an offer to enroll in minimum essential coverage under an eligible employer-sponsored plan for such month.
Treatment as affordable coverage Any employee offered a contribution described in paragraph (1) by any employer for any month shall not be treated as described in subsection (b)(1)(B) with respect to such employer for such month.
In the case of an employee whose employer makes a contribution of at least $450 per month to such employee’s health savings account, paragraph (1) shall apply to such a contribution only if such employee is enrolled in health care coverage for such month.
The amendments made by this section shall apply to months beginning in taxable years beginning after the date of the enactment of this Act.
Section 111 would allow health flexible spending arrangements and health reimbursement arrangements to offer direct transfers of unused balances into the beneficiary's health savings account without losing their stated tax treatment merely for offering the transfer. Transfers could occur at plan-year end or other times allowed by the Secretary. The provision would apply to tax years beginning after enactment and would not require plans to offer transfers.
A plan shall not fail to be treated as a health flexible spending arrangement or health reimbursement arrangement under this section or section 105 merely because such plan provides for a qualified HSA rollover distribution.
any portion of a beneficiary’s unused balance of a health flexible spending arrangement or health reimbursement arrangement at the end of any plan year (or such other times as the Secretary may provide) which is transferred in a direct trustee-to-trustee transfer to a health savings account of such beneficiary.
The amendment made by this section shall apply to taxable years beginning after the date of the enactment of this Act.
Section 112 would establish a way for entities described in section 170(c)(1), with the stated exclusion for U.S. possessions and their political subdivisions, tribal governments, and qualifying tax-exempt charities to fund equal contributions to a defined class of health savings account beneficiaries through the Secretary. A class could include all beneficiaries, those in specified states, or those in designated areas containing at least 5,000 beneficiaries. Recipients would exclude these contributions from gross income. The changes would apply to tax years beginning after enactment.
is made by the Secretary pursuant to a general funding contribution
is in an amount which is equal to the ratio of— (I) the amount of such general funding contribution, to (II) the number of account beneficiaries in such qualified class.
(I) an entity described in section 170(c)(1) (other than a possession of the United States or a political subdivision thereof) or an Indian tribal government, or (II) an organization described in section 501(c)(3) and exempt from tax under section 501(a)
(I) All account beneficiaries. (II) All account beneficiaries who reside in one or more States or other qualified geographic areas specified by the terms of the general funding contribution.
any geographic area in which not less than 5,000 account beneficiaries reside and which is designated by the Secretary as a qualified geographic area
Gross income of an account beneficiary shall not include any qualified general contribution to a health savings account of the account beneficiary.
The amendments made by this section shall apply to taxable years beginning after the date of the enactment of this Act.
Section 113 would require account trustees to provide a shareable link through which qualifying tax-exempt charities could contribute to a person's health savings account. The text would treat those payments as charitable contributions for section 170 purposes, up to $5,000 from each organization per tax year. It would apply to tax years beginning after enactment.
The trustee provides the account beneficiary with a URL (or other similar shareable link) which allows any organization described in section 501(c)(3) and exempt from tax under section 501(a) to make contributions to the account on the account beneficiary’s behalf. Any such contribution shall be taken into account as a charitable contribution for purposes of section 170 to the extent that the aggregate amount of such contributions from each such organization for any taxable year does not exceed $5,000.
The amendment made by this section shall apply to taxable years beginning after the date of the enactment of this Act.
Section 114 would treat payments by qualifying health care sharing ministry members for shared medical expenses or ministry administrative fees as medical care under the health savings account rules. It uses an existing ministry definition while disregarding one specified subclause, whose text is not supplied. The change would apply to tax years beginning after enactment.
amounts paid by a member of a health care sharing ministry (as defined in section 5000A(d)(2)(B)(ii) without regard to subclause (IV) thereof) for the sharing of medical expenses among members, or administrative fees of such ministry, shall be treated as paid for medical care.
The amendment made by this section shall apply to taxable years beginning after the date of the enactment of this Act.
Sections 115–116 would create special treatment for direct transfers from health savings accounts to accounts called Trump accounts. Seeding transfers would be limited to $5,000 per eligible recipient across all contributing health savings accounts. A separate rule would exclude an entire account balance transferred at the holder's death from both the holder's and recipient's gross income. Both types would be added to the recipient account's exempt-contribution provisions. The changes would apply in tax years beginning after enactment; eligibility and the general account rules are defined in statutory text not supplied here.
Paragraph (2) shall not apply to any qualified Trump account seeding distribution.
any amount which is distributed in a direct trustee-to-trustee transfer from a health savings account of an account beneficiary to a Trump account maintained for the benefit of any eligible individual designated by the account beneficiary.
The aggregate amount of distributions which may be treated as qualified Trump account seeding distributions with respect to any eligible individual shall not exceed $5,000, determined by taking into account all such distributions from all health savings accounts of all account beneficiaries with respect to such individual.
Treatment as exempt contributions Section 530A(c)(2)(B) of such Code is amended
The amendments made by this section shall apply to distributions made in taxable years beginning after the date of the enactment of this Act.
If, by reason of the death of the account beneficiary, the entire balance of a health savings account of the account beneficiary is paid or distributed in a direct trustee-to-trustee transfer from such health savings account to a Trump account maintained for the benefit of any eligible individual, the amount so paid or distributed shall not be includible in the gross income of either the account beneficiary or the eligible individual.
the terms Trump account and eligible individual have the meaning given such terms in section 530A(b).
Treatment as exempt contributions Section 530A(c)(2)(B) of such Code, as amended by the preceding provisions of this Act, is amended
The amendments made by this section shall apply to taxable years beginning after the date of the enactment of this Act.
Section 202 would let qualifying entities form health marketplace pools treated as employers for offering group coverage, including self-insured plans or drug-only coverage. Eligibility would depend on specified membership, employment, or dependent relationships. Pools could not base membership or enrollment rules on health status and generally would have to offer the same coverage to all members, subject to service-area and referenced insurance-law qualifications. Participation alone would not establish an employment relationship for other purposes or a joint-employer relationship.
An entity (referred to in this section as a health marketplace pool) that meets the requirements under subsection (b) shall be deemed an employer under section 3(5) for purposes of offering a group health plan or group health insurance coverage
not condition membership in the health marketplace pool on any health status-related factor relating to an individual
the health marketplace pool may not offer coverage under a group health plan or group health insurance coverage to a member of the health marketplace pool unless the same coverage is offered to all such members of the health marketplace pool.
Nothing in this subsection shall be construed as requiring a health insurance issuer or group health plan to provide coverage outside the service area of the issuer or plan, or preventing a health insurance issuer or group health plan from underwriting or from excluding or limiting the coverage on any individual, subject to the requirements under sections 701 and 702.
The health marketplace pool may provide— (i) group health insurance coverage through a contract with a health insurance issuer; or (ii) a group health plan through self-insurance.
notwithstanding any other provision of law, drug coverage, including coverage of over-the-counter drugs, as the only benefit covered by the group health plan or group health insurance coverage.
An individual shall be eligible to be a member of the health marketplace pool if such individual is— (i) a member of an entity that establishes or joins the health marketplace pool (or a dependent of such a member, as applicable); (ii) an employee of a member of an entity described in clause (i) (or a dependent of such an employee, as applicable); or (iii) an employee of an entity (or a dependant of such an employee, as applicable) controlled by a member of an entity described in clause (i).
Such rules shall be applied consistently to all members within the health marketplace pool and shall not be based in any manner on health status-related factors in accordance with sections 701 and 702.
shall not be construed as establishing under any Federal or State law— (1) an employer relationship for any purpose other than offering the group health plan or group health insurance coverage; or (2) a joint employer relationship for any purpose.
Section 203 would make related changes to definitions in the Employee Retirement Income Security Act. Membership alone would not make someone a fiduciary with respect to the pool's plan or coverage. The section would also add pool members to one referenced definition and pool coverage to another; their full effects depend on existing statutory text not reproduced in the bundle.
in paragraph (6), by inserting before the period , except (with respect to an entity meeting the requirements under section 736(b)) such term includes any member of such entity
membership in the health marketplace pool shall not by itself cause the person to be a fiduciary with respect to the group health plan or group health insurance coverage.
in paragraph (40)(A)
as a group health plan (as defined in section 733(a)(1)), or group health insurance coverage (as defined in section 733(b)(4)), offered by an entity meeting the requirements under section 736(b)
Beginning January 1, 2027, section 302 would require monthly, free public hospital price disclosures in standardized computer-readable and consumer-friendly formats. Disclosures would include cash prices, insurer-negotiated charges, and pricing formulas. Hospitals would have to accept the disclosed discounted cash price as full payment from patients choosing cash, regardless of insurance. Consumer listings would cover at least 300 services that can be scheduled in advance, or all available if fewer, through 2027 and all such services afterward. The hospital definition includes affiliated providers and suppliers, and an estimator tool would not substitute for disclosure.
on a monthly basis compile and make public (without subscription and free of charge)
as many additional hospital-selected shoppable services (or all such additional services, if such hospital furnishes fewer than 300 shoppable services) as may be necessary for a combined total of at least 300 shoppable services through December 31, 2027, after which the hospital’s prices shall include all shoppable services
The hospital shall accept the discounted cash price as payment in full from any patient that chooses to pay in cash without regard to the patient’s coverage.
The payer-specific negotiated charges, expressed as a dollar amount and clearly associated with the name of the applicable third party payer and name of each plan
the hospital also shall disclose such algorithm, percentage, formula, or criteria as set forth in its contract
Not later than January 1, 2027, the Secretary shall establish a standard, uniform method and format
ensure that such charges are made available in a machine-readable spreadsheet format
the use of an estimator tool shall not be used for purposes of compliance with any provisions in this Section.
together with any parent, subsidiary, or other affiliated provider or supplier of health care items and services without regard to whether such parent, subsidiary, or other affiliated provider or supplier operates under separate licensure, certification, or designation.
The term shoppable service means a service that can be scheduled by a health care consumer in advance
The amendment made by subsection (a) shall apply beginning January 1, 2027.
Section 302 would require annual hospital compliance reviews and a senior official's accuracy certification. Officials would have 30 days after finding a violation to request a correction plan. A hospital still noncompliant 45 days after that request would face daily penalties running from the initial finding, with caps based on hospital size and duration of noncompliance. Repeated knowing and willful violations could trigger additional penalties. The Secretary could raise penalty limits through rulemaking for violations in 2028 onward but could not waive or mitigate a penalty.
each hospital’s compliance with this subsection is reviewed not less frequently than once every year.
A senior official from each hospital (the Chief Executive Officer, Chief Financial Officer, or an official of equivalent seniority) shall attest to the accuracy and completeness of the disclosures
not later than 30 days after the date on which the Secretary determines such failure exists, the Secretary shall submit to such hospital a notification of such determination, which shall include a request for a corrective action plan
fails to comply with the requirements of this subsection by the date that is 45 days after such request is made shall be subject to a civil monetary penalty of an amount specified by the Secretary for each day (beginning with the day on which the Secretary first determined that such hospital was not complying with such requirements) during which such failure was ongoing.
(I) in the case of a hospital with 30 or fewer beds, $300 per day; (II) in the case of a hospital with more than 30 beds but fewer than 101 beds, $12.50 per bed per day (or, in the case of such a hospital that has been noncompliant with such requirements for a 1-year period or longer, beginning with the first day following such 1-year period, $15 per bed per day)
knowingly and willfully noncompliant with the provisions of this subsection two or more times during a 1-year period, the Secretary may increase any penalty otherwise applicable
with respect to violations occurring in 2028 or a subsequent year, the Secretary may through notice and comment rulemaking increase
The Secretary shall not grant or extend any waiver, delay, tolling, or other mitigation of a civil monetary penalty for violation of this subsection.
Starting July 1, 2028, section 303 would require covered laboratories to publish specified test prices online and update changed information at least monthly. Prices would include routine supporting services, and cash-paying patients could pay the disclosed discounted or minimum cash price regardless of insurance. Tests available from only one provider or supplier would be excluded, as would laboratories whose test prices are published under the hospital rules. After notice and 90 days of continued noncompliance, the Secretary could impose up to $300 daily from the initial finding; that cap could rise through rulemaking for violations in 2029 onward.
Beginning July 1, 2028, an applicable laboratory shall— (A) make publicly available on an internet website the information described in paragraph (2)
updated not less frequently than monthly, if there have been any changes to such information.
shall include the price or rate for any ancillary item or service (including specimen collection services, specimen transport, centrifugation, aliquoting, labeling, requisition processing, and standard result reporting services) that would customarily and routinely be furnished by such laboratory as part of such test
The laboratory shall accept the discounted or minimum cash price as payment in full from any patient that chooses to pay in cash without regard to the patient’s coverage.
such term does not include a laboratory with respect to which standard charges and prices for specified clinical diagnostic laboratory tests furnished by such laboratory are made available by a hospital pursuant to subsection (e)
other than such a test that is only available to be furnished by a single provider of services or supplier.
if such laboratory continues to fail to comply with such paragraph after the date that is 90 days after such notification is sent, the Secretary may impose a civil monetary penalty in an amount not to exceed $300 for each day (beginning with the day on which the Secretary first determined that such laboratory was failing to comply with such paragraph) during which such failure is ongoing.
with respect to violations occurring in 2029 or a subsequent year, the Secretary may through notice and comment rulemaking increase the per day limitation
Starting July 1, 2028, section 304 would require providers of specified imaging services that can be scheduled in advance to publish prices online and update them at least annually, unless hospital disclosures already cover those services. Cash-paying patients could use the disclosed discounted or minimum cash price regardless of insurance. Continued violations could draw daily penalties capped initially at $300 after 90 days from notice, or 90 days from submission of a requested correction plan. The cap could rise through rulemaking for violations in 2028 onward; penalties could not be waived, and this section's process would be the sole enforcement mechanism.
Beginning July 1, 2028, each provider of services or supplier that furnishes a specified imaging service, other than such a provider or supplier with respect to which standard charges and prices for such services furnished by such provider or supplier are made available by a hospital pursuant to subsection (e)
make publicly available (in accordance with paragraph (3)) on an internet website
updated not less frequently than annually.
The provider of services or supplier shall accept the discounted or minimum cash price as payment in full from any patient that chooses to pay in cash without regard to the patient’s coverage.
after the date that is 90 days after such notification is sent (or, in the case of such a provider or supplier that has submitted a corrective action plan described in clause (ii) in response to a request so described, after the date that is 90 days after such submission), the Secretary may impose a civil monetary penalty in an amount not to exceed $300 for each day
with respect to violations occurring in 2028 or a subsequent year, the Secretary may through notice and comment rulemaking increase the amount
The Secretary shall not grant or extend any waiver, delay, tolling, or other mitigation of a civil monetary penalty
this paragraph shall be the sole means of enforcing the provisions of this subsection.
an imaging service that is a Centers for Medicare & Medicaid Services-specified shoppable service (as described in subsection (e)).
Section 305 would apply annual public price-reporting rules to surgery centers with the specified hospital ownership or control connection, beginning July 1, 2028. They would publish computer-readable charges and consumer-friendly prices for at least 300 services that can be scheduled in advance, or all available if fewer, and accept the discounted cash price from cash-paying patients regardless of insurance. Estimators would not replace disclosure. Annual compliance reviews and daily penalties would apply, generally after 90 days from notice or a submitted correction plan. The initial $300 daily cap could be increased through rulemaking for violations in 2028 onward, and penalties could not be waived.
Beginning July 1, 2028, each specified ambulatory surgical center shall comply
shall compile and make public (without subscription and free of charge), for each year— (i) one or more lists, in a machine-readable format
information in a consumer-friendly format
as many additional ambulatory surgical center-selected shoppable services (or all such additional services, if such surgical center furnishes fewer than 300 shoppable services) as may be necessary for a combined total of at least 300 shoppable services
The specified ambulatory surgical center shall accept the discounted cash price as payment in full from any patient that chooses to pay in cash without regard to the patient’s coverage.
the use of an estimator tool shall not be used for purposes of compliance with any provisions in this subsection.
each specified ambulatory surgical center’s compliance with this subsection is reviewed not less frequently than once every year.
90 days after such notification (or, in the case of an ambulatory surgical center that has submitted a corrective action plan described in subparagraph (A)(ii) in response to a request so described, by the date that is 90 days after such submission) shall be subject to a civil monetary penalty
not to exceed $300 per day
with respect to violations occurring in 2028 or a subsequent year, the Secretary may through notice and comment rulemaking increase the limitation
The Secretary shall not grant or extend any waiver, delay, tolling, or other mitigation of a civil monetary penalty
an ambulatory surgical center with respect to which a hospital (or any person with an ownership or control interest (as defined in section 1124(a)(3) of the Social Security Act) in a hospital) is a person with an ownership or control interest (as so defined).
Section 306 would expand health-plan cost disclosures through a real-time online tool, with free paper or phone alternatives. Information would include applicable provider rates, the patient's share, progress toward deductibles and out-of-pocket limits, and coverage restrictions. The online tool would have to protect members from being charged more than the patient responsibility it displayed. These amendments would apply beginning January 1, 2027.
at the option such individual, through a paper or phone disclosure (as selected by such individual and provided at no cost to such individual)
(I) If such provider is a participating provider with respect to such item or service, the in-network rate (as defined in subparagraph (F)) for such item or service. (II) If such provider is not described in subclause (I), the maximum allowed dollar amount for such item or service.
The amount of cost sharing (including deductibles, copayments, and coinsurance) that the individual will incur
The amount the individual has already accumulated with respect to any deductible or out of pocket maximum under the plan
Any prior authorization, concurrent review, step therapy, fail first, or similar requirements applicable to coverage
(I) is based on an internet website; (II) provides for real-time responses
holds a member harmless for the amount of any difference in excess of the amount of the individual’s responsibility generated by the self-service tool and the amount ultimately billed or charged to the individual.
The amendments made by subsections (a) and (b) shall apply beginning January 1, 2027.
Section 306 would require monthly public files starting January 1, 2028, covering provider rates, drug rates and historical net prices, and out-of-network billed and allowed amounts, subject to stated no-claims exclusions. Files would be free, require no account, and carry an executive accuracy certification. Federal audits would cover at least 20 plans or insurers and at least 200 plans or administrative service providers under the respective audit duties, with public annual reports to Congress. Continued noncompliance 90 days after a correction-plan request would trigger a daily penalty capped at the lesser of $300 per member or $10 million. The requirements would also reach specified Medicare Shared Savings Program organizations.
Not later than January 1, 2028, and every month thereafter, each health plan shall submit to the Exchange, the Secretary, the State insurance commissioner, and make available to the public, the rate and payment information
other than such a rate in effect with a provider— (aa) that has submitted no claims; and (bb) expects to receive no claims in the then applicable calendar year for such item or service to such plan.
The historical net price paid by such plan (net of rebates, discounts, and price concessions)
other than such an amount paid to a provider that has submitted no claims for such drug to such plan.
the amount billed or charged by the provider, and the amount allowed by the plan, for each such item or service furnished during the 90-day period beginning 180 days before such date of submission by each provider that was not a participating provider
other than items and services with respect to which no claims for such item or service were submitted to such plan during such period.
accessible to individuals at no cost and without the need to establish a user account or provider other credentials.
An officer or executive of competent authority shall attest to the accuracy and completeness
The Secretary shall audit the three machine-readable files required by subparagraph (E)(ii) posted by no fewer than 20 group health plans or health insurance issuers.
The Secretary of Labor shall audit the three machine-readable files required by subparagraph (E)(ii) posted by no fewer than 200 group health plans or service providers furnishing third-party administrator services to a group health plan.
reported annually to Congress no later than July 1 of the calendar year during which the files were audited. Such report to Congress shall be accessible to the public.
fails to comply with the requirements of this subsection by the date that is 90 days after such request is made shall be subject to a civil monetary penalty
Such amount shall not exceed $300 per member per day or $10,000,000, whichever is lesser.
An applicable ACO participating in the Medicare Shared Savings Program, as defined in Section 1899 of the Social Security Act (42 U.S.C. 1395jjj), shall be subject to the requirements of this paragraph
Section 307 would require group health plan service contracts to allow access to claims, supporting records, and payment terms without unreasonable restrictions or delays exceeding 15 days. Standard claims and payment files would be free, and existing health-information privacy rules would remain applicable. Conflicting contract provisions would be void. The Secretary could impose $10,000 daily penalties for agreements violating the referenced information-access section. Plans and insurers would certify compliance annually, with an explanatory statement allowed when necessary data cannot be obtained. These changes would start with the first plan year beginning at least one year after enactment.
access to all claims and encounter information or data, and any documentation supporting claim payments, including, but not limited to, medical records and policy documents
unreasonably limit or delay access, as determined by the Secretary but in any event not longer than 15 days
limit the disclosure of pricing terms for value-based payment arrangements or capitated payment arrangements
Files shall be accessible to the plan at no cost to the group health plan.
The files shall be unmodified copies of the files sent by the Covered Service Provider to the healthcare provider. Files shall be accessible at no cost to the group health plan.
may disclose such information only in a manner that is consistent with the Health Insurance Portability and Accountability Act (HIPAA) and the privacy and security regulations promulgated thereunder
Any provision in an agreement or instrument shall be void as against public policy if such provision— (1) unduly delays or limits a group health plan
that violates the provisions of section 724, the Secretary may assess a civil penalty
in the amount of $10,000 for each day during which such violation continues.
shall annually submit to the Secretary an attestation that such plan or issuer of such coverage is in compliance
unable to obtain the information or data needed to submit the attestation required under subparagraph (A), such plan or issuer may submit a written statement in lieu of such attestation
the first plan year that begins on or after the date that is 1 year after the date of enactment of this Act.
Section 308 would require health plan service providers to give plans free quarterly information about payment formulas, fees, rebates, and alternative payment arrangements, with privacy protections and standardized data formats. Restrictive contract terms would be prohibited and void. The rules would begin for plan years at least two years after enactment under the Employee Retirement Income Security Act, and at least one year afterward for self-funded non-federal governmental plans. The text provides $100,000-per-day penalties and requires enforcement action within 90 days of awareness of a disclosure violation; its separate penalty clauses use both mandatory and discretionary wording.
With respect to plan years beginning on or after the date that is 2 years after the date of enactment of this section, not less frequently than quarterly, a health plan service provider shall provide to the group health plan or health insurance issuer the following information at no cost
Any contractual and subcontractual calculation methodologies, pricing or fee schedules, or other formulae used to determine reimbursement amounts
The total amount received or expected to be received by the health plan service provider or its subcontractors in provider or supplier rebates, fees, alternative discounts, and all other remuneration
All payment data and reconciliation information related to alternative compensation arrangements
consistent with the privacy, security, and breach notification regulations at parts 160 and 164 of title 45, Code of Federal Regulations
All data and information provided pursuant to this subsection shall comply with the following standards
shall be prohibited and, if a group health plan or health insurance issuer enters into such agreement, shall be deemed void as against public policy.
With respect to plan years beginning on or after the date that is 1 year after the date of enactment of this section, not less frequently than quarterly, a health plan service provider shall provide to the group health plan that is a self-funded, non-Federal governmental plan the following information at no cost
Any failure by a health plan service provider to comply with the requirements of this section shall result in the imposition of a civil penalty of $100,000 for each day the violation continues
The Secretary may assess a civil penalty against any person of $100,000 per day for each violation by any person of section 727.
the Secretary may assess a penalty against a health plan service provider, as defined in section 2799A–12(a) (42 U.S.C. 300gg–121(a)), of $100,000 per day for each violation
the Secretary shall initiate enforcement action under section 502 within 90 days of becoming aware of a violation
the Secretary shall initiate enforcement action under section 2723(b) (42 U.S.C. 300gg–22(b)) within 90 days of becoming aware of a violation
Section 309 would preserve state health care price-transparency requirements unless they prevent application of sections 302–305. It states that it would not affect group health plans established under the Employee Retirement Income Security Act or alter application of that law's section 514; the underlying provision is not reproduced.
shall not supersede any provision of State law which establishes, implements, or continues in effect any requirement or prohibition related to health care price transparency
except to the extent that such requirement or prohibition prevents the application of a requirement or prohibition of such sections (or amendment).
Nothing in this section shall be construed to affect group health plans established under the Employee Retirement Income Security Act of 1974, or alter the application of section 514 of such Act (29 U.S.C. 1144).
For plan years beginning January 1, 2027, or later, section 310 would require plans and insurers to send an understandable, itemized explanation of benefits within 45 days after receiving a payment request. Patients could choose mail or electronic delivery. The explanation would show network status, services and billing codes, plan payments, patient obligations, progress toward financial limits, and the service location. Related advance-estimate provisions would also require plain-language descriptions and billing codes.
For plan years beginning on or after January 1, 2027, each group health plan, or a health insurance issuer offering group or individual health insurance coverage shall, within 45 days of receiving any request for payment for an item or service under the plan, provide to the participant, beneficiary, or enrollee (through mail or electronic means, as requested by the participant, beneficiary, or enrollee) a notification (in clear and understandable language
Whether or not the provider or facility is a participating provider or a participating facility
(i) A plain language description of each item or service. (ii) All applicable billing codes for each item or service, including modifiers, using standard and commonly recognized billing code sets that are clearly identified. (iii) The amount the plan or coverage is responsible for paying for each item or service. (iv) The amount of any cost-sharing for which the participant, beneficiary, or enrollee is responsible for each item or service (as of the date of such notification). (v) The amount that the participant, beneficiary, or enrollee has incurred toward meeting the limit of the financial responsibility (including with respect to deductibles and out-of-pocket maximums) under the plan or coverage (as of the date of such notification). (vi) The site of each item or service.
A good faith estimate of the amount the plan or coverage is responsible for paying for items and services included in the estimate described in subparagraph (B), including a plain language description of each item or service and all applicable billing codes
Section 311 would require itemized bills with patient payment requests, including telehealth services, and delivery no later than 30 days after final third-party payment. Bills would identify services, prices, prior payments, billing contacts, language assistance, and charity-care information. Providers could not pursue collection without complying, or for amounts above disclosed prices or qualifying estimates unless they document medically necessary, unforeseeable additions arising from complications or patient-requested changes. Without that documentation, the estimate would bind the provider. Violations would carry penalties up to $10,000 each and a patient-favoring presumption in billing disputes.
shall include with such request a written, itemized bill
including telehealth visits or visits by other electronic means.
not later than 30 days after the health care provider or health care facility received a final payment on the provided service or supply from a third party.
(i) a plain language description of each distinct health care item or service
the price and billed amount, if different, of each distinct health care item or service
any payments made to the health care provider or health care facility by or on behalf of the individual
(v) information about the availability of language-assistance services for individuals with limited English proficiency (LEP); (vi) the identification of an office or individual at the health care provider or health care facility, including phone number and email address, that shall be able to discuss the specific details of the itemized statement and be authorized to make appropriate changes thereto; and (vii) information about the health care provider’s or health care facility’s charity care policies and instructions on how to apply for charity care.
shall not take any collections actions against an individual— (i) for any provided health care item or service unless the health care provider or health care facility has complied with paragraph (1)
exceeds the amount disclosed pursuant to Federal health care price transparency regulations
unless the provider or facility documents that the additional items or services were medically necessary due to unforeseen complications or a patient-initiated change, and could not reasonably have been anticipated.
The burden of proof under subparagraph (A)(ii) shall rest with the provider, and absent the documentation described in such subparagraph, the good faith estimate shall be binding.
The Secretary shall impose penalties on any health care provider or health care facility that fails to comply with the requirements of this section in an amount not to exceed $10,000 for each instance of failure to comply.
the presumption shall be that charges were substantially in excess of the good faith estimate
Under section 402's stated payment approach, payments for the specified Medicare Part B drugs would remain based on ASP+6, while manufacturers would pay the government rebates for the specified difference from MFP+6. The payment amendment deletes a selected-drug alternative from the referenced law. The full existing payment rules are not reproduced, so their resulting operation cannot be fully reconstructed from this source. The new rebate formulas define ASP+6 as 106% of a referenced statutory pricing amount and MFP+6 as 106% of the negotiated maximum fair price. For covered quarters beginning with the initial price-applicability period, the Secretary would report the calculation within six months after quarter-end, and manufacturers would pay within 30 days after receiving it. The rebate would equal the specified per-unit difference multiplied by the reported units. Rebates would supplement other required rebates, go to the Medicare supplementary medical insurance trust fund, and be enforced through a referenced civil-penalty provision.
(a) Maintaining payments under part B based on ASP+6 Section 1847A(b)(1)(B) of the Social Security Act (42 U.S.C. 1395w–3a(b)(1)(B)) is amended by striking or in the case of such a drug or biological product that is a selected drug and all that follows through the semicolon and inserting a semicolon.
Not later than 6 months after the end of each calendar quarter beginning on or after the first day of the initial price applicability period
Information on the sum of— (I) the amount (if any) by which— (aa) the ASP+6 payment amount (as defined in paragraph (5)) for such drug and calendar quarter, less the ASP+6 coinsurance amount for such drug and calendar quarter; exceeds (bb) the MFP+6 payment amount (as so defined) for such drug and calendar quarter, less the MFP+6 coinsurance amount for such drug and calendar quarter; and (II) the amount (if any) by which— (aa) the ASP+6 coinsurance amount (as defined in paragraph (5)) for such drug and calendar quarter; exceeds (bb) the MFP+6 coinsurance amount (as so defined) for such drug and calendar quarter.
not later than 30 days after the date of receipt from the Secretary of the information described in subparagraph (A) for such calendar quarter, provide to the Secretary a rebate that is equal to the amount specified in subparagraph (A)(ii) multiplied by the number of units specified in subparagraph (A)(i)
The rebate required under this subparagraph shall be in addition to any other rebates required under this title or title XIX
Amounts paid as rebates under paragraph (1)(B) shall be deposited into the Federal Supplementary Medical Insurance Trust Fund
The civil money penalty established under paragraph (7) of subsection (i) shall apply to the failure to comply with this subsection
The ASP+6 payment amount is equal to 106 percent of the amount determined under paragraph (4) of subsection (b)
The MFP+6 payment amount is equal to 106 percent of the maximum fair price
For selected drugs receiving the section 402 rebate, the patient's coinsurance—the share paid by the patient—would generally equal 20% of 106% of the negotiated maximum fair price. If the referenced inflation-rebate rule produces a lower amount, that lower amount would apply. Related rules would extend this approach to specified separately paid drugs in surgery centers and hospital outpatient settings. Manufacturers would meet the stated maximum-fair-price obligation through the rebate rather than a separate requirement to supply drugs at that price.
in the case of a selected drug with respect to which a rebate is paid under this subsection— (i) the amount of any coinsurance applicable under this part to an individual to whom such drug is furnished during a calendar quarter shall be equal to the MFP+6 coinsurance amount
If a rebate is required under subsection (i) with respect to a selected drug for a calendar quarter, the lesser of the amount of coinsurance computed under subparagraph (A) or the coinsurance computed under subsection (i)(5) shall apply
The MFP+6 coinsurance amount is equal to 20 percent of the MFP+6 payment amount.
The MFP+6 payment amount is equal to 106 percent of the maximum fair price
ASC conforming amendments
for which payment under this subsection is not packaged into a payment for a service furnished on or after the initial price applicability year for the selected drug
for which payment under this subsection is not packaged into a payment for a covered OPD service (or group of services) furnished on or after the initial price applicability year for the selected drug, and the payment for such drug is the same as the amount for a calendar quarter under section 1847A(b)(1)(B)
Nothing in part E of title XI or this subsection shall be construed to require a manufacturer to provide selected drugs at maximum fair prices other than through the rebate required under this subsection.
Section 501 would require a federal list of expanded-access prescription drugs selected for safety, low risk, and suitability for assessment in a pharmacy or similar setting. Licensed pharmacists, advanced practice nurses and providers, physician assistants, and other designated professionals could dispense and administer them after protocol-based patient assessments. Regulations would be due within 120 days of enactment. Conflicting or different state requirements would generally be displaced, but a state could explicitly prohibit or limit this prescribing or dispensing. A report on implementation and state opt-outs would be due within two years.
The Secretary shall establish and maintain a list of expanded-access prescription drugs.
based on safety data, evidence of low risk, and suitability for assessment in a pharmacy or similar setting
an expanded-access prescription drug may be dispensed and administered by a covered individual after conducting an appropriate patient assessment consistent with protocols to be issued by the Secretary.
Not later than 120 days after the date of enactment of this paragraph
no State or political subdivision of a State may establish, enforce, or continue in effect with respect to an expanded-access prescription drug any provision of law or legal requirement, including with respect to licensure of a covered individual, that is different from, or is in conflict with, any requirement applicable under this paragraph.
a State (excluding a political subdivision thereof) that has in effect a law explicitly prohibiting or limiting the prescribing or dispensing of an expanded-access prescription drug by a covered individual.
an individual who is licensed under applicable State law as— (i) a pharmacist; (ii) an advanced practice registered nurse; (iii) an advanced practice provider; (iv) a physician assistant; or (v) such other health care professional, as may be specified by the Secretary.
Not later than 2 years after the date of enactment of this Act, the Secretary of Health and Human Services shall submit to Congress a report on the implementation of, and State opt-outs under, paragraph (6)
Section 502 would direct the President to ensure that government-sponsored programs covered by a referenced tax-code definition include coverage for expanded-access drugs administered by covered professionals. For this provision, those professionals could administer the drugs despite state licensing or scope-of-practice restrictions. The text does not repeat section 501's state opt-out exception here, and the referenced list of government programs is not supplied.
The President shall take such steps as are necessary to ensure that each Government sponsored program includes coverage for expanded-access prescription drugs administered by covered individuals to beneficiaries of the program.
A covered individual may administer expanded-access prescription drugs pursuant to subsection (a) regardless of a provision of law or legal requirement in the State of the covered individual regarding the licensure or scope-of-practice of the individual.
The term Government sponsored program means any coverage described in section 5000A(f)(1)(A) of the Internal Revenue Code of 1986.
Section 601 would repeal paragraph 12 of Federal Reserve Act section 19(b) and section 201 of the Financial Services Regulatory Relief Act of 2006. It would also require specified supplemental reserves to be held in an Earnings Participation Account, with quarterly earnings capped at the Federal Reserve securities portfolio's previous-quarter rate, subject to a referenced exception. The Board could issue payment rules. Because the repealed provisions are not reproduced, their full effect cannot be determined from this bundle alone.
Paragraph (12) of section 19(b) of the Federal Reserve Act (12 U.S.C. 461(b)) is hereby repealed.
The supplemental reserve authorized under subparagraph (A) shall be maintained by the Federal Reserve banks in an Earnings Participation Account. Except as provided in subsection (c)(1)(A)(ii), such Earnings Participation Account shall receive earnings to be paid by the Federal Reserve banks during each calendar quarter at a rate not more than the rate earned on the securities portfolio of the Federal Reserve System during the previous calendar quarter. The Board may prescribe rules and regulations concerning the payment of earnings on Earnings Participation Accounts by Federal Reserve banks under this paragraph.
The Financial Services Regulatory Relief Act of 2006 is amended— (A) by striking section 201
The official-actions snapshot updated August 11, 2026, records House introduction on August 3, 2026, and referral that day to Energy and Commerce and seven additional committees for provisions within their jurisdictions. This describes the supplied dated snapshot, not the bill's status after that date.
Source snapshot updated 2026-08-11T15:43:19Z.
2026-08-03: Introduced in House
2026-08-03: Referred to the Committee on Energy and Commerce, and in addition to the Committees on Ways and Means, Education and Workforce, the Judiciary, Armed Services, Veterans' Affairs, Foreign Affairs, and Financial Services, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
A closer look
Reviewed version: Introduced in House · 2026-08-03. These findings describe provisions and who may benefit; they are not judgments of waste, corruption, or motive.
This review covers the supplied bill text. “None identified” does not rule out provisions in later versions or accompanying reports and disclosures.
Provisions outside the bill’s main subject, or policy changes attached to appropriations.
Findings to examine
Review of the complete supplied introduced text identifies an apparent subject-matter rider. This classification does not establish how or when it was attached.
Title VI's Federal Reserve repeal and reserve-earnings rules appear unrelated to the package's main health savings, insurance, price-disclosure, and prescription-drug subjects. This supports identifying an apparent unrelated provision, but the source does not document an amendment's attachment history or explain a financing connection.
This Act may be cited as the Great American Healthcare Act.
VI Repeal of Certain Federal Reserve System Earnings on Balances
Paragraph (12) of section 19(b) of the Federal Reserve Act (12 U.S.C. 461(b)) is hereby repealed.
The supplemental reserve authorized under subparagraph (A) shall be maintained by the Federal Reserve banks in an Earnings Participation Account.
Spending directed to particular recipients or places outside ordinary competitive or formula-based allocation.
None identified in the reviewed text
No congressionally directed spending for particular recipients or places outside competitive or formula allocation was identified after reviewing the complete supplied introduced text. This conclusion is limited to that version and does not establish absence in other versions or accompanying materials. Member requests, disclosures, committee reports, and conference materials needed to assess formal earmark status are not supplied.
Narrow exceptions, exemptions, or preferential treatment that warrant a closer look.
Findings to examine
Review of the complete supplied introduced text identifies narrow special treatment and an express exclusion that warrant scrutiny. Classification does not establish that these provisions are unjustified.
Section 114 gives qualifying health care sharing ministry members specific health savings account treatment for shared medical-expense payments and ministry administrative fees. The administrative-fee allowance is a narrow extension of the bill's broader account-spending policy; the referenced ministry definition is modified by disregarding one subclause, whose contents are not supplied.
amounts paid by a member of a health care sharing ministry (as defined in section 5000A(d)(2)(B)(ii) without regard to subclause (IV) thereof) for the sharing of medical expenses among members, or administrative fees of such ministry, shall be treated as paid for medical care.
Sections 115–116 give special treatment to health savings account transfers for eligible Trump account recipients. Seeding transfers for recipients designated by an HSA holder are exempted from a referenced distribution rule, up to $5,000 per recipient across contributing HSAs. A qualifying transfer of the entire HSA balance at the holder's death is excluded from both the holder's and recipient's gross income. These are exceptions for a specified account destination within the bill's broader HSA policy. The underlying distribution rule and recipient eligibility definition are not supplied, so the complete tax effect and eligible population cannot be established here.
Paragraph (2) shall not apply to any qualified Trump account seeding distribution.
the term qualified Trump account seeding distribution means any amount which is distributed in a direct trustee-to-trustee transfer from a health savings account of an account beneficiary to a Trump account maintained for the benefit of any eligible individual designated by the account beneficiary.
The aggregate amount of distributions which may be treated as qualified Trump account seeding distributions with respect to any eligible individual shall not exceed $5,000, determined by taking into account all such distributions from all health savings accounts of all account beneficiaries with respect to such individual.
the terms Trump account and eligible individual have the meaning given such terms in section 530A(b).
If, by reason of the death of the account beneficiary, the entire balance of a health savings account of the account beneficiary is paid or distributed in a direct trustee-to-trustee transfer from such health savings account to a Trump account maintained for the benefit of any eligible individual, the amount so paid or distributed shall not be includible in the gross income of either the account beneficiary or the eligible individual.
the terms Trump account and eligible individual have the meaning given such terms in section 530A(b).
Section 303 excludes laboratory tests available from only one provider or supplier from its specified-test disclosure requirement, benefiting the sole providers or suppliers of those tests through a narrow exception within the laboratory price-transparency policy. It does not establish an exemption from every other disclosure rule.
make publicly available on an internet website the information described in paragraph (2) with respect to each such specified clinical diagnostic laboratory test that such laboratory so furnishes
The term specified clinical diagnostic laboratory test means a clinical diagnostic laboratory test that is included on the list of shoppable services specified by the Centers for Medicare & Medicaid Services (as described in subsection (e) of this section), other than such a test that is only available to be furnished by a single provider of services or supplier.
Full text preserved for this analysis. Legislative record snapshot: Aug 11, 2026. How PlainBill uses AI