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.
The Health Care Fairness for All Act fundamentally restructures the U.S. health insurance system by largely rolling back Affordable Care Act requirements while preserving seven core consumer protections (no lifetime limits, dependent coverage to age 26, guaranteed availability and renewability, no pre-existing condition exclusions, and non-discrimination protections). The bill introduces new tax credits ($333/month for individuals, $167/month per child) and creates "Roth HSAs"—a new tax-advantaged savings account where contributions are non-deductible but medical distributions are tax-free—while phasing out traditional HSA contributions after December 31, 2025. It grants states broad flexibility to restructure insurance markets outside federal exchanges, including auto-enrollment in high-deductible plans, allows Medicare Advantage plans to fund Roth HSAs and permits "hospital care at home" programs, and makes telehealth flexibilities permanent. The bill also transforms Medicaid into a per-beneficiary quarterly payment system based on historical costs, introduces quality bonuses for top-performing states, allows states to consolidate Medicare and Medicaid for dual-eligible individuals, and strengthens hospital price transparency requirements. Roth HSA provisions take effect January 1, 2026, with Medicaid reforms beginning on a specified implementation date and phasing in over ten years.
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