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Adds a new subsection (f) terminating the medical expense deduction under subsection (a) for amounts paid in taxable years beginning after December 31, 2025, except for long-term care premiums (as defined in subsection (d)(10)).
Adds a new subsection (i) prohibiting acceptance of contributions to health savings accounts after December 31, 2025 (with exceptions for rollovers and certain employer-covered months), and replaces/amends subsection (f)(8) to specify treatment after the death of an account beneficiary (an individual who acquires the beneficiary's interest by reason of death is treated as the account beneficiary).
Redesignates existing subsection (g) as subsection (h) and inserts a new subsection (g) to include services furnished by an Acute Hospital Care at Home Program as inpatient hospital services, with specific telehealth, nursing availability, life safety, and regulatory requirements.
Adds a new prohibition on using an inpatient-only list to refuse designation of outpatient hospital services and replaces/rewrites the definition of 'off-campus outpatient department of a provider' in paragraph (21)(B); adds text clarifying Secretarial authority to promote site-neutral payment policies.
Repeals the ACA individual mandate penalty after 2024, removes the employer mandate and reporting rules, and treats employer premium-reimbursement arrangements (like HRAs) differently for key federal health laws. It restructures multiple Medicare and Medicaid payment and payment‑policy rules (including site‑neutral payments, off‑campus outpatient rules, and a new beneficiary‑based Medicaid payment with a State 'share' and optional dual‑eligible arrangement), creates an annual indigent care grant appropriation beginning in 2025, freezes most new HSA contributions after 2025 and ends the medical expense deduction (with narrow exceptions), and affirms the 2019 HHS hospital price‑transparency rule as binding.
The bill also gives States more flexibility to allow non‑Exchange individual plans and clarifies that ERISA/HIPAA should not be read to prevent employer contributions to individual coverage; it sets implementation deadlines (notably Jan 1, 2026 for many Medicare/Medicaid changes), requires agency reports/regulatory revisions, and establishes audit, enforcement, and funding‑mechanisms for the new Medicaid payment rules.
Referred to the Committee on Energy and Commerce, and in addition to the Committees on Ways and Means, and Education and Workforce, 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 April 29, 2025 by Pete Sessions · Last progress April 29, 2025