Sponsor
Bruce Westerman
Representative · R-AR
Representative · R-AR
Official title: To address the high costs of health care services, prescription drugs, and health insurance coverage in the United States, and for other purposes.
Introduced May 14, 2026 by Bruce Westerman · Last progress May 14, 2026
The bill would expand access to coverage, accelerate patient access to therapies, increase transparency, and modernize tax‑favored health accounts, but does so at the cost of substantial new administrative complexity, potential increases in federal and program spending, risks to provider finances and drug-innovation incentives, and new legal and consumer-safety tradeoffs.
Uninsured and current marketplace enrollees will have broader access and stronger consumer protections: statewide issuer acceptance (with limited exceptions), bans on preexisting-condition and genetic underwriting, tighter rating rules, expanded special enrollment windows, a new lower-cost 'copper' tier, and longer open enrollment — making coverage more available and predictable for many Americans
Taxpayers eligible for Health Savings Accounts (HSAs) gain more flexible, modernized tax-favored savings: higher indexed contribution limits, expanded qualified expenses (including menstrual care and direct primary care), limited rollovers from FSAs/HRAs, Saver's Credit election options, and bankruptcy protection for HSA balances
Patients with serious, rare, or epidemic-threat conditions can gain faster access to promising medicines through conditional/provisional approval pathways (with rolling/prioritized review and registry requirements), and insurers generally must cover conditionally/provisionally approved drugs for indicated patients — speeding access to treatments
Lower-income households and some federal employees risk losing premium tax-credit eligibility or facing reduced employer-style coverage because of HSA-treatment rules, FEHB conversions to fixed HSA deposits, and limits on corporate tax benefits — which could increase out-of-pocket costs and reduce subsidized coverage
Employers, insurers, states, PBMs, pharmacies, and providers face significant new reporting, verification, certification, and billing requirements across the bill, increasing administrative burdens, compliance costs, and potential delays in consumer services
Applying Medicare-advantage–style rates and other payment limits to targeted high-market hospitals risks sharply reducing hospital revenue for affected facilities, potentially causing service cuts, staffing losses, or closures that would harm access to care locally
Based on analysis of 13 sections of legislative text.
Reforms HSAs and ACA/market rules, tightens PBM/Part D protections, alters Medicare/Medicaid payment models, expands telehealth, and caps noneconomic damages in health cases.
Makes broad changes across federal health policy to reshape health savings accounts (HSAs), private insurance rules, Medicaid and Medicare payment systems, prescription drug and competition rules, telehealth, and medical liability. It updates tax rules affecting HSAs, creates new outreach and conversion requirements for federal employee coverage, tightens pharmacy and PBM rules in Medicare Part D, funds FTC antitrust enforcement focused on health-care providers, and imposes caps and procedures for health-care damages and attorney fees. The bill affects insurers, employers, hospitals, pharmacies, Medicare and Medicaid programs, state governments, and patients by changing eligibility, payment rates, reporting, and program design. Many provisions take effect in 2026 or the first taxable year after enactment; some changes require agency guidance or phased implementation schedules.