H.R. 6538: More Affordable Care Act

This bill, titled the More Affordable Care Act, proposes several changes aimed at improving health care and insurance coverage. Here are the main components of the bill:

Health Freedom Waiver Program

The bill establishes a Health Freedom Waiver Program allowing states to opt out of certain federal health insurance requirements. States can apply for a waiver to modify regulations provided they maintain a risk management program, such as a high-risk insurance pool. The Secretary of Health and Human Services will oversee this program.

• State notification: States must notify the Secretary at least 90 days before participating in the waiver program.
• Eligible requirements to waive: Various regulations concerning health insurance coverage can be waived, as long as the state maintains sufficient protections for consumers.

Trump Health Freedom Accounts

The bill introduces Trump Health Freedom Accounts (HFAs), which are health savings accounts available to individuals in participating states. These accounts would receive funds from tax credits typically provided to individuals under certain health care laws, thereby allowing residents to fund their health costs more flexibly.

• HFAs would accept funds transferred from credits that individuals would have received without the state waiver.
• Funds in HFAs cannot be used to pay for certain procedures, including gender transition services and abortion services.

Employee Health Insurance Credit for Small Employers

The bill provides enhanced tax credits for small employers offering health insurance in states with waivers. This is intended to encourage small businesses to provide health coverage for their employees.

• Increased credits: Small employers may receive a higher percentage of tax credits than under the existing program.
• Qualified plans: Health plans available on state exchanges would also be considered qualified for these credits.

Improved Price Reporting and Outcomes Data

The bill mandates updates to price transparency and data reporting regulations within 90 days post-enactment. The goals are:

• Provide actual price disclosures for health services instead of estimates.
• Standardize pricing information across health plans and providers.
• Ensure compliance with new price reporting regulations.
• Require public reporting of health outcomes data by providers.

Consumer Protection Standards

The legislation includes provisions to maintain consumer protections, specifically those relating to pre-existing conditions. States cannot waive these essential protections, ensuring that individuals cannot be denied coverage based on pre-existing health issues.

Process for State Waivers

The Secretary will develop a streamlined process for states to apply for various waivers under this and other federal health care laws. States may submit a single application for multiple waiver requests, simplifying administrative burdens.

Effective Date

The amendments made by this bill are set to take effect on January 1, 2026, aligning with the start of the first plan year in which states may opt-in to the waiver program.

Relevant Companies

• UNH (UnitedHealth Group): As one of the largest health insurance providers, changes in state regulations and the introduction of new health savings accounts could impact their insurance offerings and customer base.
• ANTM (Anthem, Inc.): Similar to UnitedHealth, Anthem’s products may be influenced by the changes in health policy and the waiver programs established by the bill.
• CNC (Centene Corporation): As a managed care organization, Centene could see changes in purchasing patterns and coverage options depending on state participation in the new waiver programs.