Great American Healthcare Plan

Key Points

• The bill would dramatically expand Health Savings Accounts by removing the requirement that you have a high-deductible health plan and raising annual contribution limits to match 401(k) levels (roughly $23,500 in 2026). This means almost any American could open and use a tax-free HSA for medical costs.
• Hospitals, labs, imaging centers, and ambulatory surgical centers would be required to publicly post their prices online, including the cash price and the secret rates they negotiate with each insurance company. Hospitals must update prices monthly, and penalties for noncompliance could reach $10 million for large hospitals that knowingly refuse to comply.
• HSA funds could be used for gym memberships, fitness trackers, vitamins, dietary supplements, and healthy food, up to $100-$200 per month depending on the account balance. The bill also allows HSA money to pay for health insurance premiums and direct primary care arrangements.
• Pharmacists, nurse practitioners, and physician assistants would be allowed to prescribe and dispense certain common medications directly, such as antibiotics for minor infections and maintenance drugs for chronic conditions, without requiring a doctor visit. States could opt out of this provision.
• For Medicare Part B drugs that go through the federal price negotiation process, drug manufacturers would pay rebates based on the difference between the standard payment rate and the negotiated maximum fair price. Patients' out-of-pocket costs for those drugs would be calculated on the lower negotiated price instead of the higher standard price.
• Healthcare providers would be required to send patients itemized bills within 30 days of final payment. Providers who fail to comply with price transparency rules would be blocked from taking collection actions against patients, and the burden of proof falls on the provider if charges exceed a good faith estimate.