Bill · H.R. 1776· House(119-HR-1776)
New Health Options Act of 2025
- Introduced
- 3/3/2025
- Last activity
- 3/3/2025 — Referred to the Committee on Energy and Commerce, and in addition to the Committees on Ways and Means, and Education and Workforce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
- Sponsored by
- Gary Palmer
- Cosponsors
- - 3 - 0
- Introduced
- In Committee
What this bill would do
The New Health Options Act of 2025 seeks to amend the Patient Protection and Affordable Care Act. It establishes a Reinsurance Program administered by the Secretary of Health and Human Services to provide payments to health insurance issuers to lower premiums for eligible individuals. The bill also allows certain health insurance issuers to opt out of the single risk pool and permits age premium variations that exceed actuarially justified amounts for specific plans. Additionally, it addresses out-of-network costs by allowing them to apply to deductibles and out-of-pocket maximums under certain conditions. Finally, the act requires health care providers to disclose whether cost-sharing amounts exceed charges for individuals without benefits.
Yes· 3 of 5
Does this lower what people pay for private health insurance?+6
The reinsurance program is specifically designed to provide payments to lower premiums for eligible individuals.
Does this strengthen the Affordable Care Act?+5
The bill amends the ACA to establish a new reinsurance program to lower premiums.
Would households on low incomes be better off under this?+5
The reinsurance program aims to lower insurance premiums, which disproportionately benefits lower-income individuals.
The opposite
Would people over 65 be better off under this?-4
The bill allows for higher age-based premium variations for certain insurance plans, which could increase costs for older adults.
Would retired people be better off under this?-3
The allowance for increased age-based premium variations may negatively impact retirees facing higher insurance costs.
Does this reduce what the federal government spends?-1
The bill mandates a new reinsurance program appropriation of up to $6 billion annually.
Who it would affect, and how
Potential Positive Impacts for People
-
Lower Premiums: The creation of a Reinsurance Program aims to provide payments to health insurance issuers specifically for the purpose of lowering premiums for eligible individuals (Section 2).
-
Out-of-Network Cost Application: Individuals may have the option to have out-of-network costs applied to their deductibles or out-of-pocket maximums, provided the service is covered and the charge meets specific price requirements (Section 3).
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Price Transparency: Health care providers and facilities are required to disclose to patients whether the cost-sharing amount for a service exceeds the charge for an individual without benefits (Section 4).
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Legal Recourse for Pricing Violations: Individuals harmed by a provider's failure to disclose pricing information may bring legal action for injunctive relief or damages (Section 4).
Potential Negative Impacts for People
-
Restrictions on Fund Usage: Funds received under the Reinsurance Program cannot be used to pay for certain services described in section 1303(b)(1)(B)(i) (Section 2).
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Changes to Age Premium Variation: Certain plans may be allowed to vary premium rates by age by more than an actuarially justified amount (Section 2).
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Out-of-Network Cost Limitations: The ability to apply out-of-network costs to deductibles or out-of-pocket maximums is subject to specific constraints, such as the charge being equal to or less than the lowest amount recognized by the plan or the 25th percentile of charges in the State (Section 3).
Groups and Interests Ranking
Every group the model scored this bill for, from -10 to +10. Hover a score for the reason it gave.
- Healthcare
- Reduces Private Insurance Premiums+6Increases Affordable Care Act Support+5Improves Healthcare Access+3
- Demographic And Interest Groups
- Good For Low Income Households+5Good For Middle Class Households+4Good For Seniors-4Good For Retirees-3
- Economy And Finance
- Reduces Government Spending-1
- 1/21/2026
- 1 Cosponsor added.
- 12/18/2025
- 1 Cosponsor added.
- 11/25/2025
- 1 Cosponsor added.
- 3/3/2025
- Referred to the Committee on Energy and Commerce, and in addition to the Committees on Ways and Means, and Education and Workforce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
- Introduced in House
Rick AllenRepublican · Georgia
Warren DavidsonRepublican · Ohio
Bruce WestermanRepublican · Arkansas