Affordable CHOICE Act

This bill amends the Affordable Care Act to create a public health insurance option, a government-run health plan offered through the Health Insurance Exchanges starting in 2027. The goal is to provide affordable, high-quality coverage.

Sec. 2, Public health insurance option: The Secretary of Health and Human Services must create a public health insurance option, offered only through the Exchanges, not by private insurers. It must follow Exchange rules and offer bronze, silver, and gold plans. The Secretary can contract for administrative tasks but cannot transfer insurance risk to contractors. States may create advisory councils to recommend policies on quality, cost, and public awareness. The Secretary must collect data to set premiums and provider payment rates.

Sec. 2, Financing: Premiums must be geographically adjusted and fully cover health benefits and administrative costs, including a contingency margin. Premiums can only vary based on allowed factors. Provider payment rates are to be negotiated; if no agreement, rates default to Medicare fee-for-service rates, modified for new services. Prescription drug rates are also negotiated, defaulting to Medicare rates. A Treasury account will hold all receipts and disbursements, with start-up funding authorized and repayable over 10 years.

Sec. 2, Provider participation: Providers must be state-licensed or certified. Medicare and Medicaid providers are automatically included unless they opt out. The Secretary must also allow other providers to join.