Sponsors (2)
The bill would expand affordable, standardized public-plan options on Exchanges to lower consumer costs and widen choice, but does so at the risk of higher federal spending, reduced private-plan market share, and pressure on provider finances and administrative systems.
People buying Exchange plans (and other eligible enrollees) gain a federally offered, standardized public option (bronze, silver, gold) beginning in 2027, increasing plan choices and a clear baseline offering.
Consumers — especially patients with chronic conditions and Medicare beneficiaries — may pay lower provider prices where the Secretary negotiates rates or defaults to Medicare rates, reducing out-of-pocket costs.
Hospitals and other providers that already participate in Medicare or Medicaid are automatically eligible to serve public option enrollees unless they opt out, making it easier to assemble networks and maintaining provider participation.
Hospitals and other providers could receive lower reimbursements where the public option defaults to Medicare rates, straining provider finances and potentially leading to reduced services or access problems for patients.
Private insurers and small-group markets may lose market share on Exchanges because the Secretary exclusively offers the public option, which could reduce competition and limit private plan choices for individuals and small employers.
Taxpayers could face higher federal spending to establish and subsidize the public option, increasing budgetary costs and potential pressure on deficits or future taxes.
Based on analysis of 2 sections of legislative text.
Creates a federally run public health insurance option sold on ACA Exchanges nationwide with federally set premiums and negotiated provider payment rates.
Introduced January 8, 2026 by Sheldon Whitehouse · Last progress January 8, 2026
Creates a federally run public health insurance option to be sold on ACA Exchanges nationwide for plan years beginning January 1, 2027. The federal government (through HHS) will offer bronze, silver, and gold plans, set geographically adjusted premiums to cover costs, negotiate provider payment rates (with a default to original Medicare rates if negotiations fail), and manage start-up funding and a Treasury account for receipts and disbursements.