Great American Healthcare Act

The Great American Healthcare Act modifies health savings accounts (HSAs), creates health marketplace pools, strengthens hospital and insurer price transparency, protects patient access to cancer therapies, expands access to certain prescription drugs, and repeals a Federal Reserve earnings provision. Title I, Health Savings Accounts For All Act of 2026, increases HSA contribution limits, removes the high-deductible health plan mandate, allows HSA funds to be used for health insurance, direct primary care, healthy food, vitamins, dietary supplements, and sports and fitness expenses, permits rollovers to children, parents, or grandparents, provides bankruptcy protections equivalent to retirement funds, allows employer mandate satisfaction through HSA contributions, permits rollovers from health care FSAs and HRAs, allows charitable contributions to HSAs, covers health care sharing ministry expenses, and creates qualified Trump account seeding distributions. Title II, Health Marketplace for All Act of 2026, deems health marketplace pools as an employer for offering group health plans or coverage, including prescription-only drug plans, and makes conforming amendments to ERISA. Title III, Patients Deserve Price Tags Act, strengthens hospital price transparency requirements, increases price transparency for clinical diagnostic laboratory tests and imaging services, adds ambulatory surgical center price transparency, strengthens health coverage transparency requirements, increases group health plan access to health data, provides oversight of administrative service providers, states that state law is preempted only in case of conflict, requires explanation of benefits, and requires itemized bills from providers. Title IV, Protecting Patient Access to Cancer and Complex Therapies Act, maintains Medicare Part B payments for certain drugs and biological products and establishes a rebate by manufacturers for selected drugs subject to maximum fair price negotiation. Title V establishes a list of expanded-access prescription drugs designated by the Secretary based on safety and low risk, and requires government sponsored programs to cover such drugs administered by covered individuals, preempting state licensure or scope-of-practice laws. Title VI repeals paragraph (12) of section 19(b) of the Federal Reserve Act regarding earnings on balances and makes conforming amendments.