[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3080 Introduced in House (IH)]
<DOC>
119th CONGRESS
1st Session
H. R. 3080
To ensure health care fairness and affordability for all Americans
through universal access to equitable health insurance tax credits,
reformed health savings accounts, and strengthened consumer
protections, and for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
April 29, 2025
Mr. Sessions introduced the following bill; which was 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
_______________________________________________________________________
A BILL
To ensure health care fairness and affordability for all Americans
through universal access to equitable health insurance tax credits,
reformed health savings accounts, and strengthened consumer
protections, and for other purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE; PURPOSES; TABLE OF CONTENTS.
(a) Short Title.--This Act may be cited as the ``Health Care
Fairness for All Act''.
(b) Purposes.--The purposes of this Act are as follows:
(1) Elimination of individual and employer mandates.--To
eliminate mandates on individuals and employers, and other tax
requirements, imposed under Public Law 111-148.
(2) Providing states with alternative, affordable coverage
options.--To provide greater flexibility in providing States
with options in making affordable health insurance coverage
available by eliminating certain mandates under Public Law 111-
148, while retaining essential consumer protections, by
promoting health savings accounts to pay for such coverage and
long-term care coverage, while permitting States to continue
coverage as provided under such public law.
(c) Table of Contents.--The table of contents of this Act is as
follows:
Sec. 1. Short title; purposes; table of contents.
Sec. 2. Definitions.
TITLE I--REVISION OF FEDERAL HEALTH LAW
Subtitle A--Elimination of Employer and Individual Mandates
Sec. 101. Repeal of individual health insurance mandate.
Sec. 102. Repeal of employer health insurance mandate.
Sec. 103. Clarifying employer's ability to reimburse employee premiums
for purchase of individual health insurance
coverage.
Subtitle B--Limitation on Application of Federal Health Plan
Requirements
Sec. 121. Limiting application of requirements to consumer protections.
Sec. 122. Offering of basic health insurance; protection of assets from
liability or attachment or seizure.
Sec. 123. Ensuring access to short-term limited duration insurance.
Sec. 124. Making telehealth flexibilities permanent.
Subtitle C--Health Insurance Tax Benefit
Sec. 131. Health insurance tax benefit.
Sec. 132. Application of portion of unused tax credits by States for
indigent health care.
Sec. 133. Medicaid option of enrollment under private plan and
contribution to an HSA.
Sec. 134. Repeal of reporting requirements relating to employee health
insurance premiums and health plan
benefits.
Sec. 135. Report.
Subtitle D--Medicare Reforms
Sec. 141. Physician-owned hospitals.
Sec. 142. Prohibiting the use of an inpatient-only list in designating
hospital outpatient services under the
Medicare program.
Sec. 143. Promoting Medicare site-neutral payments.
Sec. 144. Medicare Advantage contributions to Roth HSAs for chronically
ill enrollees.
Sec. 145. Extending acute hospital care at home waiver flexibilities.
TITLE II--IMPROVING HEALTH SAVINGS ACCOUNTS TO PROMOTE ACCOUNTABILITY
Sec. 201. Transition to non-deductible HSAs.
Sec. 202. Elimination of medical expense deduction.
Sec. 203. Treatment of HSA after death of account beneficiary.
Sec. 204. Treatment of direct patient care arrangements.
TITLE III--STATE FLEXIBILITY IN REGULATION OF HEALTH INSURANCE COVERAGE
Sec. 301. State flexibility in regulation of health insurance coverage.
TITLE IV--MEDICAID PAYMENT REFORM
Sec. 401. Medicaid payment reform to ensure equitable access to care.
TITLE V--PRICE TRANSPARENCY
Sec. 501. Promoting transparent hospital prices for consumers.
SEC. 2. DEFINITIONS.
Except as otherwise provided, in this Act:
(1) Basic health insurance.--The term ``basic health
insurance'' is defined in section 122(a).
(2) Default health insurance coverage.--The term ``default
health insurance coverage'' is defined in section 121(b)(4)(B).
(3) Exchange.--The term ``Exchange'' means an Exchange
established under title I of Public Law 111-148.
(4) Health insurance coverage; group health plan, etc.--The
terms defined in section 2791 of the Public Health Service Act,
including ``health insurance coverage'', ``group health plan''
``individual market'', shall apply.
(5) Limited benefit insurance.--The term ``limited benefit
insurance'' is defined in section 122(b).
(6) Secretary.--The term ``Secretary'' means the Secretary
of Health and Human Services.
(7) State.--The term ``State'' includes the District of
Columbia, Puerto Rico, the United States Virgin Islands,
American Samoa, Guam, and the Northern Mariana Islands.
TITLE I--REVISION OF FEDERAL HEALTH LAW
Subtitle A--Elimination of Employer and Individual Mandates
SEC. 101. REPEAL OF INDIVIDUAL HEALTH INSURANCE MANDATE.
Section 5000A of the Internal Revenue Code of 1986 is amended by
adding at the end the following new subsection:
``(h) Termination.--This section shall not apply to months
beginning after December 31, 2024.''.
SEC. 102. REPEAL OF EMPLOYER HEALTH INSURANCE MANDATE.
(a) In General.--Chapter 43 of the Internal Revenue Code of 1986 is
amended--
(1) by striking section 4980H, and
(2) by striking the item relating to section 4980H from the
table of sections for such chapter.
(b) Repeal of Related Reporting Requirements.--Subpart D of part
III of subchapter A of chapter 61 of such Code is amended by striking
section 6056 and by striking the item relating to section 6056 in the
table of sections for such subpart.
(c) Conforming Amendments.--
(1) Section 6724(d)(1)(B) of such Code is amended by
striking clause (xxv).
(2) Section 6724(d)(2) of such Code is amended by striking
subparagraph (HH).
(3) Section 1513 of Public Law 111-148 is amended by
striking subsection (c).
(d) Effective Dates.--
(1) In general.--Except as otherwise provided in this
subsection, the amendments made by this section shall apply to
months and other periods beginning more than 30 days after the
date of the enactment of this Act.
(2) Repeal of study and report.--The amendment made by
subsection (c)(3) shall take effect on the date of the
enactment of this Act.
SEC. 103. CLARIFYING EMPLOYER'S ABILITY TO REIMBURSE EMPLOYEE PREMIUMS
FOR PURCHASE OF INDIVIDUAL HEALTH INSURANCE COVERAGE.
An employer health care arrangement, such as a health or medical
reimbursement arrangement (HRA) or other employment plans, under which
an employer reimburses an employee for the premiums for the purchase of
individual health insurance coverage does not constitute a group health
plan for any purposes, including for purposes of applying any of the
following:
(1) The Public Health Service Act (including sections 2711
and 2714 of such Act, 42 U.S.C. 300gg-11, 300gg-14).
(2) Public Law 111-148.
(3) The Internal Revenue Code of 1986 (other than for
purposes of section 36B of such Code).
(4) The Employee Retirement Income Security Act of 1974.
(5) The HIPAA privacy regulations (as defined in section
1180(b)(3) of the Social Security Act, 42 U.S.C. 1320d-
9(b)(3)).
(6) The Health Insurance Portability and Accountability Act
of 1996.
(7) COBRA continuation coverage under title XXII of the
Public Health Service Act (42 U.S.C. 300bb-1 et seq.), section
4980B of the Internal Revenue Code of 1986, or title VI of the
Employee Retirement Income Security Act of 1974 (29 U.S.C. 1161
et seq.).
Subtitle B--Limitation on Application of Federal Health Plan
Requirements
SEC. 121. LIMITING APPLICATION OF REQUIREMENTS TO CONSUMER PROTECTIONS.
(a) Removal of Public Law 111-148 Plan Requirements, Other Than
Certain Consumer Protections.--
(1) In general.--Notwithstanding any other provision of
law, with respect to group health plans and health insurance
coverage whether or not offered through an Exchange, except as
provided in paragraphs (2) and (3), the provisions of title
XXVII of the Public Health Service Act (42 U.S.C. 300gg et
seq.) as in effect on the day before the date of the enactment
of Public Law 111-148 shall apply instead of the provisions of
such title as in effect after such date.
(2) Public law 111-148 consumer protections continuing to
be applied.--The following sections of the Public Health
Service Act, that were added or amended by subtitles A and C of
title I of Public Law 111-148, shall continue to apply to group
health plans and to health insurance coverage offered in the
individual and group market:
(A) No lifetime or annual limits.--Section 2711 (42
U.S.C. 300gg-11; relating to no lifetime or annual
limits), except in the case of limited benefit
insurance (as defined in section 122(b)).
(B) Dependent coverage through age 26.--Section
2714 (42 U.S.C. 300bb-14; relating to extension of
dependent coverage).
(C) Modified guaranteed availability.--Section 2702
(42 U.S.C. 300gg-1; relating to guaranteed availability
of coverage), subject to paragraph (3) and subsection
(c).
(D) Guaranteed renewability.--Section 2703 (42
U.S.C. 300gg-2; relating to guaranteed renewability of
coverage).
(E) Prohibiting pre-existing condition
exclusions.--Section 2704 (42 U.S.C. 300gg-3; relating
to prohibition on preexisting conditions).
(F) Prohibiting discrimination based on health
status.--Section 2705 (42 U.S.C. 300gg-4; relating to
prohibiting discrimination against individual
participants and beneficiaries based on health status),
subject to subsection (c).
(G) Non-discrimination in health care.--Section
2706 (42 U.S.C. 300gg-5; relating to non-discrimination
in health care).
(3) Application of a late enrollment penalty for those
without continuous coverage.--
(A) In general.--In the case of an individual who
seeks to enroll in health insurance coverage and who,
as of the effective date of such enrollment, does not
have a continuous period of at least 12 months of
creditable coverage, there shall be imposed a late
enrollment penalty in the form of an increase in the
monthly premiums for coverage of under the plan of 20
percent of the monthly premium otherwise determined for
each consecutive full 12-month period (ending before
such effective date) in which the individual was not
enrolled in creditable coverage. Such increase shall
apply during a period, to be specified under
regulations of the Secretary but in no case longer than
3 times the length of the most recent period in which
the individual did not have continuous coverage.
(B) State waiver.--A State may apply to the
Secretary for a waiver of the provisions of
subparagraph (A) and the application of alternative
provisions providing incentives for State residents to
enroll in creditable coverage and maintain continuous
creditable coverage. The Secretary shall approve such
waiver if the Secretary determines that the alternative
provisions provide similar or greater incentives for
such enrollment than the incentives otherwise
applicable.
(4) Coordinating implementation of pre-public law 111-148
phsa provisions with public law 111-148 consumer protections.--
(A) In general.--In applying this subsection, the
provisions described in paragraph (2) shall be treated
as if they were included in title XXVII of the Public
Health Service Act, as in effect before the date of
enactment of Public Law 111-148, and, with respect to
group health plans and health insurance coverage
offered in connection with such plans, in part 7 of
subtitle B of title I of the Employee Retirement and
Income Security Act of 1974 (29 U.S.C. 1181 et seq.),
and, with respect to group health plans, in chapter 100
of the Internal Revenue Code of 1986 as follows:
(i) Lifetime limits; dependent coverage.--
The provisions described in paragraphs (2)(A)
and (2)(B) shall be treated as included--
(I) with respect to group health
plans (and health insurance coverage
offered with respect to such plans),
under subpart 2 of part A of title
XXVII of the Public Health Service Act
(42 U.S.C. 300gg-11 et seq.) and
subpart B of part 7 of subtitle B of
title I of the Employee Retirement and
Income Security Act of 1974 (29 U.S.C.
1181 et seq.);
(II) also with respect to group
health plans, under subchapter B of
chapter 100 of the Internal Revenue
Code of 1986; and
(III) with respect to individual
health insurance coverage, under
subpart 2 of part B of title XXVII of
the Public Health Service Act (42
U.S.C. 300gg-15 et seq.).
(ii) Remaining provisions.--The provision
described in paragraph (2) (other than in
subparagraph (A) or (B) of such paragraph)
shall be treated as included--
(I) with respect to group health
plans (and health insurance coverage
offered with respect to such plans),
under subpart 1 of part A of title
XXVII of the Public Health Service Act
(42 U.S.C. 300gg et seq.) and subpart A
of part 7 of subtitle B of title I of
the Employee Retirement and Income
Security Act of 1974 (29 U.S.C. 1181 et
seq.);
(II) also with respect to group
health plans, under subchapter A of
chapter 100 of the Internal Revenue
Code of 1986; and
(III) with respect to individual
health insurance coverage, under
subpart 1 of part B of title XXVII of
the Public Health Service Act (42
U.S.C. 300gg-41 et seq.).
(B) Conflicting provisions.--In the case described
in paragraph (1) where there is a conflict between a
provision described in paragraph (2) and a provision of
law described in paragraph (1), the provision described
in paragraph (2) shall control and the Secretary, in
consultation with the Secretary of the Treasury and the
Secretary of Labor, shall establish such rules as may
be necessary to carry out this subparagraph.
(5) Conforming amendments.--
(A) ERISA.--Section 715 of the Employee Retirement
Income Security Act of 1974 (29 U.S.C. 1185d) is
amended--
(i) in subsection (a), by striking
``subsection (b)'' and inserting ``subsections
(b) and (c)''; and
(ii) by adding at the end the following new
subsection:
``(c) Additional Exception.--Pursuant to section 121 of the Health
Care Fairness for All Act, the provisions of part A of title XXVII of
the Public Health Service Act referred to in subsection (a), other than
those provisions specified in section 121(a)(2) of the Health Care
Fairness for All Act, shall not apply to plans and coverage described
in subsection (a), whether or not the plans or coverage are offered
through an Exchange established by Public Law 111-148.''.
(B) IRC.--Section 9815 of the Internal Revenue Code
of 1986 is amended--
(i) in subsection (a), by striking
``subsection (b)'' and inserting ``subsections
(b) and (c)''; and
(ii) by adding at the end the following new
subsection:
``(c) Additional Exception.--Pursuant to section 121 of the Health
Care Fairness for All Act, the provisions