Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, 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.
H.R. 6538, the "More Affordable Care Act" introduced in December 2025, would allow states to opt out of core Affordable Care Act requirements starting January 1, 2026, provided they maintain a high-risk insurance pool for uninsured residents. Under the bill, participating states would redirect federal premium tax credits and cost-sharing reduction funds into new "Trump Health Freedom Accounts" for eligible residents instead of traditional ACA insurance subsidies, while imposing restrictions on coverage for gender transition procedures and abortion services. The legislation also expands the small employer health insurance tax credit in participating states from 35-50% to 50% with extended eligibility, and requires the Department of Health and Human Services to issue new regulations within 90 days mandating transparent disclosure of healthcare prices and standardized outcomes data reporting by providers. This bill would fundamentally reshape health insurance options for millions of Americans in states that choose to participate, potentially affecting how federal healthcare subsidies are distributed and what services are covered.
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