With Republicans in control, the time has finally come to provide practical health care solutions to reduce costs and improve care. It can be done with a single, clean bill that the majority of Americans will cheer and Democrats will struggle to justify their opposition. The plan does not require any vote to repeal the Affordable Care Act because the plan simply circumvents it.
Here are the clear provisions that right what President Barack Obama did wrong. Republicans should send it to the president’s desk as soon as possible.
1. Catastrophic plans across state borders (effective from January 1, 2026)
Bring back the popular catastrophic insurance plans that Obamacare made illegal. From next year, any recognized insurer will be allowed to sell such plans nationally. No mandatory benefits, no obligations. Empower insurers to underwrite, give them the ability to set a price on pre-existing conditions and offer whatever deductible they choose. This will provide many Americans with the low premium and high deductible coverage they demand.
SENATE REPUBLICANS LAND ON OBAMACARE FIX, TEE UP DUELING VOTES WITH DEMS
2. Eligibility for Universal HSA and Higher Contribution Limits (effective January 1, 2027)
Health Savings Accounts (HSA) should be accessible to everyone. Every American—whether on a catastrophic plan, an employer plan, a Medicare Advantage plan, or even a traditional Medicare plan—is eligible for a tax-free HSA. Contribution limits will increase to the levels recommended in the most recent Senate reconciliation package (approximately $8,000 per individual/$16,000 per family, indexed for inflation). Fuel these bills with some tariff revenue. Millions of families in the coming decades will have a powerful, portable tool to control costs.
3. High-risk state pools and mental health subsidies
Everyone wants to help care for those most in need, but we need to do that more efficiently. Matching federal seed money (capped per state) will help participating states ramp up or expand at-risk populations and mental health programs. Naturally, citizenship verification is required. Let the fifty states experiment and discover what really works, instead of letting Washington pretend it has all the answers.
4. Price transparency and cash prices
Every provider must post cash prices and offer every patient – insured or uninsured – a transparent cash option at the time of scheduling. “We can arrange this through insurance for $1,400, or you can pay cash today for $400.” Sunlight is still the best disinfectant.
5. End the unlimited tax exemption for mega hospitals
Limit the tax-free revenue threshold for nonprofit health systems to $5 billion. Large nonprofit hospital chains that act like government monopolies do not need excessive payouts. Have you ever noticed that the billion-dollar healthcare systems have the largest and most beautiful buildings in the city and always seem to be in new construction? There is room for non-profit organizations, but at some point government subsidies are enough.
6. Emergency care is provided, but is invoiced
The government must end federal subsidies for emergency care. If states want to subsidize uncompensated emergency room visits, they are free to do so with their own dollars.
7. Real health plans and association purchasing pools
Any group—trade associations, churches, alumni groups, even Costco’s 40 million members—can work together across state lines to negotiate rates with insurers and providers. Bigger pools mean better prices. This is the free market’s answer to the question, “If you like your union plan, you can keep it.”
8. Subsidy extension by one year
Extend the current increased ACA subsidies through December 31, 2026. By giving families certainty and preventing immediate loss of coverage, Republicans buy time for these real solutions to take effect. But they also give every Democrat a reason to vote for the bill by keeping those subsidies in place for another year. The reality is that Americans cannot afford to be saddled with thousands more premiums, but the country cannot afford to continue subsidizing outrageously expensive health insurance premiums. Offer a compromise of a one-year extension in exchange for the above points coming into effect.
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This bill consists of eight parts and is short enough to be read in the House of Representatives in twenty minutes. It immediately delivers lower premiums (catastrophic plans), permanent consumer power (HSAs for every American), and real protection for the truly sick (high-risk state pools). It ends the most egregious hospital monopolies, enforces price transparency, and stops the abuse of “free” emergency rooms.
Most importantly, it is politically bulletproof. Democrats should vote against extending subsidies, against lower premiums for young people, against HSAs, against price transparency, and against helping the chronically ill – all in one vote. Good luck explaining that during the 2026 midterm elections.
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Republicans have said for years that they had a better plan than Obamacare. This is it. It’s simple, it’s popular and it’s done. Pass it now, sign it before New Year’s, and show Americans what real health care choice looks like.
The clock is ticking. Submit an invoice. Keep the promises. The American people have waited long enough.
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