Great American Healthcare Plan

Bill Number: H.R. 8324
Origin Chamber: House
Congress: 119th Congress, Session 2
Policy Area: Taxation
Status: Introduced
Latest Action: 2026-04-16: Referred to the Committee on Energy and Commerce, and in addition to the Committees on Ways and Means, Education and Workforce, the Judiciary, Armed Services, Veterans' Affairs, and Foreign Affairs, 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.
Last Updated: 2026-07-01T08:08:12Z

AI-Generated Summary

Purpose The bill, titled the "Great American Healthcare Plan," amends the Internal Revenue Code and Public Health Service Act to expand health savings accounts (HSAs), create mechanisms for broader access to group health coverage, strengthen price transparency requirements for hospitals and insurers, protect patient access to certain drugs, and allow expanded dispensing of certain prescription drugs.

Key Provisions

Health Savings Accounts (Title I): Increases annual contribution limits to match those under section 402(g) of the Internal Revenue Code, removes the requirement for coverage under a high-deductible health plan, permits HSA funds for health insurance premiums, direct primary care arrangements, and certain wellness expenses (healthy food, vitamins, dietary supplements, and sports/fitness costs up to monthly caps based on account balance). Allows rollovers to children, parents, or grandparents; treats certain pre-establishment medical expenses as qualified; permits administrative error corrections before tax filing deadlines; provides bankruptcy protections equivalent to retirement accounts; allows employer contributions to satisfy employer mandate requirements; permits rollovers from FSAs and HRAs; authorizes qualified general and charitable contributions; and treats health care sharing ministry payments as medical expenses.
Health Marketplace for All (Title II): Deems qualifying "health marketplace pools" as employers under ERISA for the purpose of offering group health plans or coverage, including plans limited to prescription or over-the-counter drugs. Requires pools to operate in good faith without conditioning membership on health status, maintain nondiscrimination rules, and allow self-insurance or contracts with issuers.
Price Transparency (Title III): Strengthens hospital requirements to post standard charges (gross, discounted cash, payer-specific negotiated, and de-identified maximum/minimum) monthly in machine-readable formats, expands shoppable services to all by 2028, and mandates senior official attestations. Adds similar transparency rules for clinical diagnostic laboratory tests, imaging services, and ambulatory surgical centers. Requires insurers to provide real-time cost-sharing tools, detailed rate and payment files (including in-network rates and historical net prices), and itemized explanations of benefits. Grants group health plans expanded access to claims and encounter data from service providers, with penalties for noncompliance.
Cancer and Complex Therapies (Title IV): Adjusts Medicare Part B payment and coinsurance for selected drugs subject to maximum fair price negotiation under the Inflation Reduction Act, requiring manufacturers to pay rebates to maintain ASP+6 payments while applying MFP+6-based coinsurance.
Expanded-Access Prescription Drugs (Title V): Directs the Secretary to establish a list of low-risk expanded-access prescription drugs and permits dispensing and administration by pharmacists, advanced practice registered nurses, physician assistants, and other specified professionals after patient assessment. Includes state opt-out authority and requires coverage under government-sponsored programs.

Significant Changes to Existing Law

Removes the high-deductible health plan requirement for HSA eligibility and expands qualified medical expenses.
Creates a new ERISA category for health marketplace pools to offer group coverage.
Imposes detailed monthly public posting and attestation requirements beyond current hospital price transparency rules, with tiered civil monetary penalties scaled by hospital bed count and duration of noncompliance.
Mandates insurer disclosure of negotiated rates, historical net prices, and claims data in standardized machine-readable files.
Modifies Medicare reimbursement mechanics for negotiated drugs to preserve higher payment levels via manufacturer rebates.
Allows non-physician professionals to dispense designated drugs, preempting conflicting state scope-of-practice laws except where states explicitly opt out.

Potential Impacts

On government agencies: Increases oversight and enforcement duties for the Departments of Health and Human Services, Labor, and Treasury, including annual compliance reviews, audits of machine-readable files, and penalty collection.
On citizens: Expands HSA flexibility and contribution capacity; improves consumer access to price information for hospitals, labs, imaging, and insurers; may lower out-of-pocket costs through transparency tools and itemized bills; and broadens access to certain drugs via non-physician dispensing.
On international relations: None directly addressed in the legislation.

Main Stakeholders Affected

Individuals and families using HSAs or seeking health coverage.
Employers, health insurance issuers, and new health marketplace pools.
Hospitals, clinical laboratories, imaging providers, ambulatory surgical centers, and their parent or affiliated entities.
Pharmaceutical manufacturers of selected drugs.
Pharmacists, advanced practice providers, physician assistants, and other licensed health professionals.
Federal agencies responsible for tax administration, Medicare, Medicaid, and health plan regulation.
State governments (particularly regarding insurance regulation and opt-out authority).

Notable Legal, Constitutional, or Political Implications

Introduces new civil monetary penalties and attestation requirements that are deemed material to federal payments.
Creates federal preemption of certain state laws on price transparency and drug dispensing, with explicit state opt-out provisions for the latter.
Modifies ERISA fiduciary and employer definitions to accommodate marketplace pools without creating broader joint-employer status.
Establishes detailed data-sharing mandates between plans and service providers, overriding certain contractual limitations.

This summary was generated by AI and may contain inaccuracies. Refer to the official source document for the authoritative text.

Sponsor

Rep. Burlison, Eric [R-MO-7]

Cosponsors (11)

Rep. Barrett, Tom [R-MI-7], Rep. McClintock, Tom [R-CA-5], Rep. Fuller, Clay [R-GA-14], Rep. Moore, Barry [R-AL-1], Rep. Mills, Cory [R-FL-7], Rep. Davidson, Warren [R-OH-8], Rep. Brecheen, Josh [R-OK-2], Rep. Crane, Elijah [R-AZ-2], Rep. Cloud, Michael [R-TX-27], Rep. Higgins, Clay [R-LA-3], Rep. Biggs, Sheri [R-SC-3]

Recent Actions

2026-04-16: Referred to the Committee on Energy and Commerce, and in addition to the Committees on Ways and Means, Education and Workforce, the Judiciary, Armed Services, Veterans' Affairs, and Foreign Affairs, 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.
2026-04-16: Referred to the Committee on Energy and Commerce, and in addition to the Committees on Ways and Means, Education and Workforce, the Judiciary, Armed Services, Veterans' Affairs, and Foreign Affairs, 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.
2026-04-16: Referred to the Committee on Energy and Commerce, and in addition to the Committees on Ways and Means, Education and Workforce, the Judiciary, Armed Services, Veterans' Affairs, and Foreign Affairs, 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.
2026-04-16: Referred to the Committee on Energy and Commerce, and in addition to the Committees on Ways and Means, Education and Workforce, the Judiciary, Armed Services, Veterans' Affairs, and Foreign Affairs, 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.
2026-04-16: Referred to the Committee on Energy and Commerce, and in addition to the Committees on Ways and Means, Education and Workforce, the Judiciary, Armed Services, Veterans' Affairs, and Foreign Affairs, 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.
2026-04-16: Referred to the Committee on Energy and Commerce, and in addition to the Committees on Ways and Means, Education and Workforce, the Judiciary, Armed Services, Veterans' Affairs, and Foreign Affairs, 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.
2026-04-16: Referred to the Committee on Energy and Commerce, and in addition to the Committees on Ways and Means, Education and Workforce, the Judiciary, Armed Services, Veterans' Affairs, and Foreign Affairs, 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.
2026-04-16: Introduced in House
2026-04-16: Introduced in House

Bill Versions

Great American Healthcare Plan — issued 2026-04-16 — PDF (151 pages)