The Healthcare Liberation & Medicare Plan B Relief Act of 2025

Final Fiscal Edition — Complete Legislative Framework

Table of Contents

Title I — Consumer Protection & Guaranteed Coverage

Title II — Guaranteed Issue and Fair Pricing

Title III — Universal Premium Conversion & Employee Healthcare Freedom

Title IV — Market Competition and Cost Reduction

Title V — Interstate Licensure Reciprocity

Title VI — Healthcare Liberation and Medicare Plan B Relief

Title VII — Health Freedom & Interstate Choice

 Sec. 701 Purpose and Findings

 Sec. 702 Voluntary Health Care Associations

 Sec. 703 Interstate Sale of Health Insurance

 Sec. 704 Oversight and Reporting

 Sec. 705 Enforcement and Federal Funding Reductions

Title VIII — Severability

Section 2 — Statutory Summary

Section 3 — For the People Explainer

Index

A Framework for Market-Based Healthcare Reform, Medicare Part B Relief, and State Fiscal Realignment Without Federal Subsidies

Prepared by: John Dady

https://citizensagainsttyranny.net

citizensagainsttyranny1776@gmail.com

Title I — Consumer Protection & Guaranteed Coverage

• Achieve universal, guaranteed, and financially secure healthcare access for all Americans.

• Ensure every individual can obtain comprehensive coverage with minimal financial risk and maximum personal choice.

• Reform economic incentives in the healthcare delivery system to achieve sustainable cost reduction.

• Accomplish all of the above without federal subsidies, bailouts, or taxpayer-financed insurance expansions — relying instead on private-market competition, individual empowerment, and payroll-tax parity to restore affordability and solvency.

Title II — Guaranteed Issue and Fair Pricing

Sec. 201. Universal Access

• Insurers shall guarantee coverage for all applicants regardless of health status or pre-existing conditions.

• No policy may impose lifetime or annual limits on essential benefits.

Sec. 202. Rate Parity and Transparency

• Premiums shall be determined based only on the following actuarially valid factors: Age, Geographic location, Family size, and Verified tobacco use.

• Insurers must publish pricing formulas and average rate data annually.

• No additional rating factors may be applied beyond those specified in this section.

Sec. 203. Out-of-Pocket Caps

• Individual annual maximum: $2,500.

• Family annual maximum: $5,000.

• Preventive care, chronic-condition management, and generic maintenance prescriptions are exempt from deductibles.

Sec. 204. Telehealth Access and Coverage

• All Qualified Health Plans (QHPs) authorized under this Act shall provide coverage for telehealth and virtual-care services on the same basis and at the same reimbursement rate as equivalent in-person services.

• Licensed physicians, nurse practitioners, and allied professionals practicing under an interstate licensure agreement pursuant to Title V may deliver telehealth services to patients located in any participating state.

• Nothing in this section shall restrict the use of secure audio-visual, digital, or remote-monitoring platforms for providing covered telehealth services, provided that patient privacy standards under the Health Insurance Portability and Accountability Act (HIPAA) are maintained.

• Insurers may not impose higher deductibles, copayments, or network restrictions for telehealth services compared with equivalent in-person care.

Title III — Universal Premium Conversion & Employee Healthcare Freedom

Sec. 301. Purpose

The purpose of this Title is to give employees direct control over their healthcare dollars by converting employer health-insurance contributions into tax-free stipends paid directly to each worker. This ensures every American has personal ownership of their healthcare purchasing power, ending dependence on employer-selected plans and restoring consumer choice in a competitive private market.

Sec. 302. Universal Premium Conversion (Tax-Free Stipend System)

• All employer health-insurance premium contributions shall be converted into tax-free healthcare stipends of equivalent value, paid directly to employees through regular payroll.

• The stipend shall appear as a distinct line item labeled “Healthcare Stipend (Non-Taxable)” on each paycheck.

• Employers shall deduct applicable FICA contributions from the stipend before payment. Such deductions shall be credited to the new FICA revenue account established under Title VI of this Act.

• The stipend shall be excluded from gross income for federal and state tax purposes and shall not affect eligibility for tax-advantaged accounts or credits.

• This section applies to all employers and employees without exception.

• Employees may use their healthcare stipends to purchase or maintain any Qualified Health Plan (QHP) authorized under this Act, including individual, association, or interstate plans.

• The tax-free healthcare stipend system established under this Title shall not take effect until all provisions of this Act are fully implemented and operational, including: the establishment of QHPs and standards under Title I; repeal of Certificate of Need laws and activation of price transparency under Title IV; certification of interstate reciprocity and licensure systems under Titles V and VII; and creation and funding of the new FICA payroll-contribution accounts under Title VI. Upon certification of those prerequisites, implementation of the stipend system shall begin within 24 months.

Title IV — Market Competition and Cost Reduction

• All states shall repeal Certificate of Need laws for hospitals and healthcare facilities within 12 months of enactment.

• No state may reinstate any law restricting construction, licensing, or service expansion of healthcare facilities based on competitor approval.

• Hospitals and providers must display real-time prices for all common procedures and treatments in plain language.

• Nurse practitioners and physician assistants shall have full prescriptive authority for maintenance and chronic medications.

Title V — Interstate Licensure Reciprocity

Physicians, nurses, and allied professionals licensed in one state shall be permitted to practice in any participating state without additional barriers. The Secretary of Health and Human Services shall maintain a national licensure verification system to facilitate cross-state practice and ensure uniform professional standards.

Title VI — Medicare Affordability and Payroll Alignment

• Medicare Part B premiums shall be reduced or eliminated for qualifying seniors through new FICA payroll contributions established under this Act.

• These dedicated contributions shall constitute a permanent, self-sustaining revenue source exclusively for Medicare Part B cost offsets and affordability stabilization.

• Upon activation of the new FICA funding stream, state obligations to pay Medicare Part B premiums and cost-sharing for dual-eligible beneficiaries shall be greatly reduced or terminated, with no loss of benefits to affected individuals.

• No additional general-fund appropriations or federal subsidies shall be required or authorized for this purpose.

Title VII — Health Freedom & Interstate Choice

Sec. 701. Purpose and Findings

• Ensures that all Americans have the right to purchase, join, or participate in voluntary Health Care Associations (HCAs) and interstate insurance markets under consistent federal consumer-protection and portability standards.

• Expands affordable options by removing artificial state barriers and allowing competitive plan sales across state lines.

• Protects patient freedom while maintaining solvency, transparency, and accountability under federal law.

Sec. 702. Voluntary Health Care Associations

• Authorizes any group of individuals, independent workers, or organizations to form or join an HCA for the purpose of negotiating or purchasing group health-insurance coverage.

• HCAs shall be treated as large-group plans under ERISA and exempt from conflicting state small-group mandates.

• Membership shall be open and nondiscriminatory, with public annual reporting and audited reserves.

Sec. 703. Interstate Sale of Health Insurance

• Any insurer licensed and in good standing in one state may offer Qualified Health Plans (QHPs) in any other participating state, subject to federal consumer protections and the solvency standards of its home state.

• Two or more states may enter into Interstate Health Insurance Compacts recognizing each other’s approvals and filings.

• The Secretary of Health and Human Services shall publish a Model Compact Framework to promote reciprocity and streamline certification.

Sec. 704. Oversight and Reporting

• The Secretaries of Labor and Health and Human Services shall jointly monitor and report annually to Congress on:

– The number of active HCAs and participating insurers;

– Average premium reductions and coverage expansion resulting from interstate competition; and

– State participation in Interstate Compacts.

Sec. 705. Enforcement and Federal Funding Reductions

• Beginning upon expiration of the twenty-four (24) month implementation period established under this Act, any State that fails to implement, enforce, or that actively obstructs the provisions of this Act—including interstate health-insurance reciprocity, the recognition of Health Care Associations (HCAs), or other material obligations required under Titles I through VII—shall incur a five percent (5%) reduction in all federal financial assistance otherwise payable to that State for each fiscal year of noncompliance.

• If the State remains non-compliant for a period of six (6) months following the initial reduction, the penalty shall increase by an additional five percent (5%), resulting in a total ten percent (10%) reduction in all federal financial assistance payable to that State for each succeeding fiscal year until the Secretary of Health and Human Services certifies full compliance.

• The Secretary of Health and Human Services, in coordination with the Secretary of the Treasury, shall publish in the Federal Register a list of States determined to be in non-compliance and shall implement such reductions through proportional offsets or withholdings from federal disbursements otherwise due to the affected State.

• Upon verified compliance, the Secretary shall certify restoration in the Federal Register, and full federal funding shall resume prospectively. Any funds withheld or reduced during the period of noncompliance shall not be retroactively reimbursed or restored.

• This section is enacted pursuant to the Spending Clause of the Constitution (Art. I, §8, cl. 1) and shall serve as the exclusive enforcement mechanism ensuring State adherence to the consumer-protection, portability, and transparency standards established under this Act.

Title VIII — Severability

If any provision of this Act or its application is held invalid, the remainder shall not be affected.

SECTION 2 – STATUTORY SUMMARY

Purpose

Protect patients, cut costs through competition, and empower workers with direct healthcare control — without requiring new federal subsidies, appropriations, or taxpayer-financed insurance programs.

Key Reforms

• Guaranteed coverage regardless of health status

• Out-of-pocket cap $2,500 / $5,000

• Employer premiums become tax-free stipends for workers

• Mandatory repeal of state CON laws

• Expanded nurse authority for prescription renewals

• Real-time price transparency

• Interstate licensure reciprocity

• Voluntary health-care associations and interstate insurance choice

• Independent contractors and sole proprietors eligible for group-rate coverage

• Reduced Medicare Part B premiums funded entirely by new FICA revenue created under this Act

SECTION 3 – FOR THE PEOPLE EXPLAINER

• You keep your coverage — insurers can’t drop you or charge more for pre-existing conditions.

• Families save big: yearly out-of-pocket cap $5,000 per family (down from ~$14,000+ today).

• Your money, your choice: employer premiums become tax-free stipends you control.

• Simple refills: nurses can renew long-term meds — no unnecessary visits.

• Transparent prices: hospitals must post real prices so you can compare costs.

• More doctors, more clinics: repealing anti-competitive laws increases access.

• Cross-state freedom: buy your plan from any state; groups can negotiate better rates.

• Independent workers and small-business owners gain equal access to group-rate coverage.

• Seniors benefit: Medicare Part B premiums reduced or eliminated — funded entirely by new FICA contributions under this Act.

• States save billions annually as their responsibility for paying Medicare Part B premiums on behalf of low-income seniors who are dually eligible is greatly reduced or terminated under the new FICA-funded system.

• State accountability: non-compliant states face federal funding reductions Index

References indicate primary Titles and Sections within this Act.

A

Affordability and payroll alignment – Title VI

Association Health Plans – Title VII

C

Certificate of Need (CON) laws – Title IV

Consumer protection – Title I

F

FICA contributions (new payroll funding stream) – Title VI

Freedom of health choice – Title VII

H

Health Care Associations (HCAs) – Title VII

Healthcare stipends (tax-free) – Title III

HIPAA privacy for telehealth – Title II, Sec. 204

I

Interstate licensure reciprocity – Title V

Interstate sale of health insurance – Title VII

M

Medicare Part B relief – Title VI

Market competition – Title IV

S

State savings (dual-eligible relief) – Title VI

Stipend implementation timeline – Title III

T

Telehealth access and coverage – Title II, Sec. 204

Tobacco-use rate adjustment – Title II, Sec. 202