Great American Healthcare Act
Sponsored By: Representative Burlison, Eric [R-MO-7]
Introduced
Summary
A nationwide push for transparent health prices and clearer patient billing. This bill would force hospitals, labs, imaging centers, insurers, and plans to publish standardized, machine‑readable prices and give patients itemized bills and clear explanations of benefits.
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Bill Overview
Analyzed Economic Effects
7 provisions identified: 2 benefits, 0 costs, 5 mixed.
Hospital and medical price protections
If enacted, hospitals, clinical labs, imaging centers, and many ambulatory surgical centers would have to post machine-readable price lists. Hospitals must post monthly and accept the posted discounted cash price as full payment from cash-paying patients. Providers would have to give you an itemized bill within 30 days after a final third-party payment and could not start collections until those itemized-bill rules are met. Federal rules would not replace state price-transparency laws unless a state law blocks the federal rule.
Expanded Health Savings Account rules
If enacted, HSAs would allow a clear above-the-line deduction for cash contributions and add an explicit age-50 catch-up linked to indexing. HSAs could pay for direct primary care and certain wellness items, with monthly wellness caps of $100, $150, or $200 depending on account balance. Charities could give to HSAs through a trustee URL (gifts treated as charitable up to $5,000 per contributing organization), and limited one-time seeding transfers up to $5,000 per person would be allowed. An employer offer to contribute $450 per month to an HSA would count as offering minimum essential coverage for that month and comparable employer contributions rules would apply.
Monthly plan rate reports and audits
If enacted, health plans would send three public, machine-readable files every month starting January 1, 2028. Files must show dollar rates for items and drugs, plan and provider identifiers, pricing formulas, and come with an officer attestation and a plain-language guide. The government would audit many plans and could fine plans that fail to fix problems, with penalties up to $300 per member per day (subject to aggregate caps).
Stronger fiduciary data access rules
If enacted, group health-plan contracts would have to let plan fiduciaries get full claims, encounter, and payment data and the pricing rules supporting payments. Plans must give quarterly, no-cost files in standard HIPAA formats and not delay access longer than 15 days. Vendors or providers that withhold data could face stiff ERISA penalties, including specified daily fines for continuing violations.
Pharmacy access for certain prescriptions
If enacted, the Secretary would create a list of expanded-access prescription drugs and issue protocols within 120 days. Licensed pharmacists and other covered clinicians could dispense or administer these drugs after a patient assessment under those protocols. The President would be asked to ensure government programs cover these drugs when given by covered clinicians, and States could opt out only by passing a clear prohibition.
Medicare Part B drug price changes
If enacted, certain high-cost Part B drugs with a government maximum fair price would trigger manufacturer rebates to Medicare and a coinsurance change. Beneficiary coinsurance would be based on the maximum fair price plus 6 percent (MFP+6) and set at 20% of that amount for quarters when a rebate is paid. Drug makers must receive quarterly reports and deposit rebate payments into the Medicare SMI Trust Fund.
Federal Reserve earnings and repeals
If enacted, the bill would repeal a specific paragraph of the Federal Reserve Act and strike section 201 of the 2006 Financial Services Regulatory Relief Act. It would also create an Earnings Participation Account that Federal Reserve banks would fund each quarter at a rate no higher than the Fed's securities yield from the prior quarter. The Board of Governors would write rules for these accounts.
Sponsors & CoSponsors
Sponsor
Burlison, Eric [R-MO-7]
MO • R
Cosponsors
There are no cosponsors for this bill.
Roll Call Votes
No roll call votes available for this bill.
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