Health Marketplace for All Act of 2025
Sponsored By: Senator Rand Paul
Introduced
Summary
Creates a new federal framework that treats "health marketplace pools" as ERISA employers for offering group health plans. The bill would let organizations form voluntary pools that offer uniform group coverage while clarifying who counts as an employer or fiduciary.
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Bill Overview
Analyzed Economic Effects
4 provisions identified: 3 benefits, 0 costs, 1 mixed.
Fair membership and enrollment rules
If enacted, this would require pools to form a risk pool in good faith and not deny membership for health reasons. You would be able to enroll in a pool plan if you are a member, an employee of a member, or a dependent. Pools could set enrollment rules, but they must apply the same rules to everyone and cannot base them on health status.
Pools can act like employers
If enacted, this would let qualifying marketplace pools be treated like an employer only to offer group health plans. This could let members access group coverage through the pool. Membership alone would not make you a plan fiduciary.
Pools set rates and run plans
If enacted, pools could set plan or product rates themselves or let a contracting insurer set rates. Pools could offer coverage via an insurer contract or by self-insuring. Pools could also provide administrative services and offer drug-only plans or include drugs in other plans. Rates may vary for people in the pool, subject to existing nondiscrimination rules.
Multiple pools can operate locally
If enacted, this would allow more than one health marketplace pool to form and operate in the same geographic area. There would be no statutory limit on the number of pools in a community. This could increase choice or competition in local markets.
Sponsors & CoSponsors
Sponsor
Rand Paul
KY • R
Cosponsors
Cynthia Lummis
WY • R
Sponsored 12/9/2025
Roll Call Votes
No roll call votes available for this bill.
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