H.R. 10015: Great American Healthcare Act

This bill would make several changes to health savings accounts (HSAs), healthcare price transparency rules, and access to certain medications, while also creating new reporting and disclosure requirements for health plans and service providers.

Health savings account changes

The bill would expand how HSAs can be used and funded. It would increase the ways people can contribute to HSAs and allow money to be rolled over into an HSA from flexible spending accounts (FSAs), health reimbursement arrangements (HRAs), and certain family accounts. It would also allow HSA funds to be used for additional types of expenses, including some wellness and fitness costs, food, and contributions to certain charity or sharing-ministry arrangements.

The bill would also add some protections and tax-related rules for HSAs. It would provide bankruptcy protection for HSA assets, and it would allow HSA contributions to count toward meeting certain employer health coverage requirements.

In addition, the bill includes rules connecting HSAs with “Trump accounts.” It would allow up to $5,000 to be transferred from an HSA into a Trump account on a tax-exempt basis, and it would allow HSA balances to be rolled over into a Trump account when the account holder dies.

Healthcare price transparency and data access

The bill would strengthen requirements for hospitals, ambulatory surgical centers, and health plans to make pricing information easier to access. These entities would have to publicly disclose more detailed pricing and rate information, provide self-service comparison tools, and make certain data available in machine-readable files.

Health plans would also have to give plan fiduciaries broader access to claims and other plan data. The bill would require health plan service providers to give plans detailed quarterly information about claims, payments, rebates, and compensation, using standard HIPAA-compatible formats and without charging for the data.

The bill would restrict contract terms that delay or block access to this information. It also includes penalties for noncompliance, including corrective action requirements and daily fines. For some violations involving service-provider data access, the bill provides for penalties of up to $100,000 per day.

Expanded-access drugs

The bill would create a federal list of “expanded-access” drugs that certain licensed health professionals could dispense or administer under protocols set by the Department of Health and Human Services (HHS). It would limit conflicting state laws, while allowing states to opt out in certain ways.

The bill would require HHS to report on the program and would direct certain government programs to cover these drugs. It would also repeal a provision of federal law related to Federal Reserve earnings.

Relevant Companies

• CI — Cigna offers health plans and benefits administration services that could be affected by new claims-data disclosure requirements, transparency rules, and broader access to plan information.
• UNH — UnitedHealth Group operates health insurance and benefits services that could be directly impacted by expanded reporting obligations, fiduciary data access rules, and transparency requirements.
• HUM — Humana provides health insurance products and could be affected by requirements to disclose pricing, claims, rebate, and compensation data.
• ELV — Elevance Health is a large health insurer that could face added data-sharing and transparency obligations under the bill.
• CVS — CVS Health, through its insurance and pharmacy-benefit businesses, could be affected by rules governing claims, rebates, and compensation disclosures.
• MCK — McKesson could be indirectly affected if expanded-access drug distribution or dispensing rules change how certain medications are handled in the healthcare system.
• CAH — Cardinal Health may be indirectly impacted by expanded-access drug provisions that could affect medication distribution and administration channels.