Sponsors
The bill increases price transparency, state flexibility for market stabilization, and short‑term affordability supports for many consumers while imposing substantial new administrative, technical, and compliance burdens, introducing coverage restrictions and documentation requirements, and reducing some subsidy generosity — a trade‑off between greater market disclosure/control and higher operational costs plus narrower access for certain services and populations.
Millions of consumers — especially uninsured, self-pay, and cash-paying patients — gain clear, comparable hospital, lab, ASC, and plan price information and access to advertised discounted cash prices, letting them shop and often pay less out of pocket.
Plan enrollees and participants get stronger consumer protections and clearer billing: itemized EOBs, hold‑harmless rules when estimates differ, monthly machine‑readable data, and enforcement provisions improve ability to detect surprise bills and compare plan costs.
People buying individual market coverage in participating states may see lower premiums because the bill provides funding and authorizes states to use §1332 mechanisms (reinsurance/invisible high‑risk pools) to stabilize premiums.
Hospitals, labs, ASCs, health plans, and vendors face substantial new administrative, technical, and compliance obligations and daily civil penalties, which will impose costs that could be passed to patients or strain smaller providers and vendors.
Mandated public disclosure of negotiated rates, contract terms, and algorithmic payment rules risks confidentiality disputes, commercial data exposure, and potential re‑identification of sensitive information, prompting litigation or disrupted payer–provider contracting.
The bill creates access barriers and coverage limits for reproductive and gender‑affirming care (prohibiting HAA funds for abortion and gender‑transition procedures, narrowing CSR eligibility for abortion‑covering plans, and a broad exclusion definition) and adds photo‑ID/document requirements for Exchange enrollees, which may delay or deny coverage for women, transgender people, immigrants, and低‑
Based on analysis of 10 sections of legislative text.
Requires minimum monthly enrollee premium contributions that limit advance premium tax credits, adds Exchange ID checks and HAAs, expands §1332 reinsurance/pool options, mandates broad provider price transparency and ERISA disclosures.
Introduced December 9, 2025 by Roger Wayne Marshall · Last progress December 9, 2025
Imposes new limits and verification steps for Marketplace premium assistance, creates a new mechanism to route advance premium tax credits into Healthcare Affordability Accounts (HAAs) for certain plan years, expands state options under §1332 to support invisible high‑risk pools and reinsurance programs, strengthens hospital and ambulatory surgical center price‑transparency requirements, and requires broad quarterly disclosure of pricing, rebates, and payment flows from health plan service providers to group health plans and issuers. Effective dates vary by provision (notably premium‑credit caps for taxable years after 12/31/2025; Exchange HAA facilitation for plan years 2027–2031; hospital/ASC transparency deadlines in 2026–2027; ERISA disclosures two years after enactment).