More Affordable Care Act
Summary
The "More Affordable Care Act" (H.R. 6538) proposes a health freedom waiver program allowing states to waive certain requirements of the Affordable Care Act (ACA) starting January 1, 2026, provided they maintain a high-risk insurance pool. It also establishes "Trump Health Freedom Accounts" for eligible residents in waiver states to receive funds equivalent to premium tax credits and cost-sharing reductions they would have otherwise received under the ACA. The bill further modifies the small employer tax credit and aims to improve price reporting and outcomes data transparency.
Expected Effects
If enacted, this bill could lead to significant changes in healthcare access and affordability, varying by state. States could gain flexibility in designing their healthcare systems, potentially leading to lower premiums for some. However, it could also result in reduced coverage and consumer protections in states that choose to waive ACA requirements. The creation of Trump Health Freedom Accounts aims to ensure that individuals in waiver states still receive financial assistance.
Potential Benefits
- State Flexibility: States gain greater control over their healthcare systems, allowing for tailored solutions.
- Potential Cost Savings: Waiver programs could lead to innovative approaches that reduce healthcare costs.
- Continued Financial Assistance: Trump Health Freedom Accounts aim to provide financial support to eligible residents in waiver states.
- Increased Transparency: Enhanced price reporting and outcomes data could empower consumers to make informed decisions.
- Small Business Support: Modifications to the small employer tax credit could incentivize small businesses to offer health insurance.
Potential Disadvantages
- Reduced Coverage: Waiver of ACA requirements could lead to fewer essential health benefits being covered.
- Increased Premiums for Some: Without ACA protections, individuals with pre-existing conditions could face higher premiums.
- Uncertainty and Complexity: The waiver program could create a patchwork of different healthcare systems across states, leading to confusion.
- Potential for Discrimination: The bill restricts the use of Trump Health Freedom Accounts for certain services, raising concerns about discrimination.
- Impact on Risk Pools: The effectiveness of high-risk insurance pools in mitigating risk to insurance premium costs is uncertain.
Most Disadvantaged Areas:
Constitutional Alignment
The bill's constitutionality is complex. Article I, Section 8 grants Congress the power to lay and collect taxes, duties, imposts and excises, to pay the debts and provide for the common defense and general welfare of the United States. The ACA was previously upheld under this clause. The waiver program raises questions about the federal government's role in regulating healthcare and the balance of power between the federal government and the states, potentially implicating the Tenth Amendment, which reserves powers not delegated to the federal government to the states respectively, or to the people. The restrictions on the use of Trump Health Freedom Accounts could raise concerns under the First Amendment if they are interpreted as infringing on religious freedom or freedom of expression.
Impact Assessment: Things You Care About ⓘ
This action has been evaluated across 19 key areas that matter to you. Scores range from 1 (highly disadvantageous) to 5 (highly beneficial).