Health Care Freedom for Patients Act of 2025
Description
This bill would provide HSA payments to certain individuals, expand catastrophic plan eligibility, and restrict funding for noncitizens.
Summary
What it does
This bill would provide federal payments into Health Savings Accounts for certain individuals aged 18 to 64 with bronze or catastrophic insurance plans and incomes up to 700% of the federal poverty level. It proposes to expand eligibility for catastrophic health plans to all individuals regardless of age and would restrict federal funding for Medicaid, CHIP, and exchange plans regarding gender-transition procedures and certain noncitizens. Additionally, the measure would reduce federal Medicaid matching rates for states that provide health benefits to non-qualified aliens and would adjust cost-sharing reductions for specific silver plan enrollees.
Who is affected
The bill affects individuals aged 18 to 64 with incomes up to 700% of the federal poverty level who are enrolled in bronze or catastrophic health insurance exchange plans, as well as silver plan enrollees with incomes up to 250% of the federal poverty level. It also impacts noncitizens seeking Medicaid or CHIP coverage, individuals seeking gender-transition procedures through federal programs or exchange plans, and all adults who wish to enroll in catastrophic health plans. Additionally, state Medicaid programs are affected if they provide health benefits to non-qualified aliens or cover gender-transition procedures.
Key provisions
- Health Savings Account federal deposits. Provides federal payments of $1,000 or $1,500 into the Health Savings Accounts of individuals aged 18 to 64 who have bronze or catastrophic exchange plans and incomes up to 700% of the federal poverty level during 2026 and 2027.
- Expansion of catastrophic plan eligibility. Removes current age and exemption restrictions to allow any individual to enroll in a catastrophic health insurance plan starting in 2027.
- Medicaid and CHIP funding restrictions for noncitizens. Reduces federal matching rates for states providing Medicaid expansion benefits to certain non-qualified aliens and makes coverage optional during the immigration status verification process.
- Prohibition on gender-transition procedure coverage. Bans exchange plans from covering gender-transition procedures as an essential health benefit and prohibits federal Medicaid and CHIP payments for such procedures.
- Cost-sharing reductions for silver plans. Allocates funds beginning in 2027 for cost-sharing reductions for individuals enrolled in silver-level health plans with incomes up to 250% of the federal poverty level.
Fiscal impact
Not applicable: No CBO cost estimate available
Effective dates
The bill establishes federal payments into health savings accounts for the 2026-2027 period. Provisions regarding cost-sharing reductions and expanded eligibility for catastrophic health plans are scheduled to begin in 2027.
Relationship to existing law
The bill modifies existing Medicaid and Children's Health Insurance Program (CHIP) regulations regarding noncitizen eligibility and federal matching rates, and it expands access to catastrophic health plans currently restricted by age or exemption status. It also amends standards for health insurance exchange plans by restricting gender-transition procedures as an essential health benefit and adjusting cost-sharing reduction eligibility.
Stated purpose
The bill aims to expand health insurance options and financial assistance by providing federal payments to Health Savings Accounts for certain exchange enrollees, removing age restrictions on catastrophic health plans, and establishing new cost-sharing reductions. Additionally, it seeks to modify federal funding requirements for Medicaid and CHIP by restricting coverage for certain noncitizens and prohibiting federal payments for gender-transition procedures.