UNITED STATES CONGRESS

SESSION OF 2026

IN THE HOUSE OF REPRESENTATIVES / SENATE

SPONSORED BY: John Dady

AN ACT

To liberate the healthcare market, establish portability of Employer-Sponsored Insurance, eliminate anti-competitive mandates, eliminate Medicare Part B premiums, secure Social Security solvency, and for other related purposes.

Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled, as follows:

THE HEALTHCARE MARKET LIBERATION ACT

SECTION 1: PURPOSE AND FINDINGS

This Act addresses the affordability crisis in American healthcare by shifting Employer-Sponsored Insurance (ESI) from a trapped corporate benefit to a portable, worker-owned asset. This Act mandates the structural liberation of the healthcare market to drive down baseline costs, followed by the activation of worker-owned Health Savings Accounts (HSAs) and the capture of FICA revenue to eliminate Medicare Part B premiums and secure the long-term solvency of Social Security.

SECTION 2: QUALIFIED HEALTH COVERAGE (QHC) STANDARDS & THE GUARANTEED PATIENT BILL OF RIGHTS

To be certified as Qualified Health Coverage (QHC), a health plan must meet the following mandatory consumer standards:

(a) Guaranteed Issue: No individual shall be denied enrollment or coverage based on medical history or pre-existing conditions.

(b) Deductible as Total Liability: The annual deductible shall serve as the absolute Total Annual Out-of-Pocket Maximum. Once the deductible is met, the patient is responsible for $0 in further cost-sharing, copays, or coinsurance for the remainder of the calendar year.

(c) Patient Liability Caps: The Total Annual Out-of-Pocket Maximum (Deductible) shall not exceed $2,500 for an individual or $5,000 for a family per calendar year.

(d) Rating Variable Limits: Premiums for QHC plans are strictly limited to a maximum variance ratio of 2-to-1 for age, 1.5-to-1 for tobacco use, and 1.5-to-1 for geographic location.

SECTION 3: PHASE 1 — MARKET LIBERATION AND COST REDUCTION

The structural reforms listed below shall be executed according to the mandatory transition milestones set forth in subsection (h) to dismantle monopolies and drive down the baseline cost of healthcare delivery prior to Phase 2 conversion:

(a) Simple Menu Price Standard & Real-Time Cash Mandate: All hospitals, clinics, surgery centers, and testing facilities must publicly post and provide True Cash Prices for all medical procedures and services—including inpatient and outpatient hospital care, surgery, imaging, labs, and clinical visits—starting with the 300 Most Common Procedures.

(b) The $0 Bill Enforcement: If a provider fails to post True Cash Prices as required under subsection (a) or bills a patient above the posted menu price, the bill is legally rendered $0.00.

(c) Group of One Mandate: Every individual and 1099 independent worker is legally classified as a "Group of One," granting them the right to purchase Qualified Health Coverage (QHC) at large-corporate group rates.

(d) Federal Passport & Interstate Competition: Any QHC-certified plan approved in one state may be offered and sold in all 50 states, preempting state-level benefit mandates. No state shall prohibit a citizen from purchasing a plan approved in another state.

(e) Telehealth Freedom: Providers licensed in one state may treat patients in all 50 states via telehealth. States are prohibited from requiring a physical "brick-and-mortar" office presence in the patient's state.

(f) The CON Hammer: States must repeal all Certificate of Need (CON) laws, regulations, and programs within 12 months of enactment. Any State failing to complete full CON repeal within 12 months shall incur an immediate 5% reduction in federal Medicaid administrative matching funds, increasing to 10% at 18 months, and 15% at 24 months, continuing until full repeal is certified by the Secretary of Health and Human Services.

(g) Front-Line Provider Empowerment & Chiropractic Parity:

* Nurse Practitioners (NPs) and Physician Assistants (PAs) shall exercise full independent prescriptive authority within their clinical scope.

* Registered Nurses (RNs) are authorized to renew non-controlled maintenance medications for up to 180 days for stable patients with a documented history; Licensed Practical Nurses (LPNs) are authorized for a 90-day refill if patient vitals are stable.

* Pharmacists are authorized for "Test and Treat" protocols (Strep, Flu, UTI) and clinical dosage adjustments.

* Chiropractic care is defined as an essential medical service; QHC plans are prohibited from requiring a physician referral or imposing visit caps more restrictive than those for physical therapy or primary care visits.

(h) Mandatory Phase 1 Transition Benchmarks:

* Month 6 Milestone (Price Transparency Live): Not later than 6 months after enactment, 100% of hospitals, clinics, surgery centers, and testing facilities must publish True Cash Prices for the 300 Most Common Procedures. Any facility failing to meet this deadline forfeits federal Medicare and Medicaid reimbursement for all unposted procedures and triggers immediate $0 Bill enforcement on Day 1 of Month 7.

* Month 12 Milestone (CON Repeal & QHC Market Readiness): Not later than 12 months after enactment, States must complete repeal of all Certificate of Need (CON) laws or incur initial federal healthcare funding reductions, and certified QHC plans shall open for interstate and Group of One enrollment so workers can compare plans 6 months prior to ESI conversion.

* Month 18 Milestone (Employer Wind-Down & HSA Setup): Between Month 12 and Month 18, every employer providing Employer-Sponsored Insurance shall calculate each worker's total combined ESI allocation (employer contribution plus employee payroll deduction), issue written notice of that exact dollar amount to the worker, and establish the worker's personal Health Savings Account (HSA) to guarantee zero gap in coverage upon Phase 2 activation.

SECTION 4: DISMANTLING VERTICAL INTEGRATION & PBM REFORM

(a) Mandatory Structural Separation: No corporate entity or parent company shall simultaneously own or control a Health Insurance Carrier, a Pharmacy Benefit Manager (PBM), and a Hospital or Provider Group. All integrated healthcare conglomerates shall complete operational firewalling within 12 months and complete full legal divestiture into separate, independent companies within 18 months of enactment, coinciding with the completion of Phase 1.

(b) PBM Accountability: PBMs are prohibited from retaining manufacturer rebates; 100% of any rebate must be applied at the point of sale to lower the patient's out-of-pocket cost. Spread pricing—charging a health plan more for a prescription drug than the amount paid to the dispensing pharmacy—is strictly prohibited.

SECTION 5: PHASE 2 — MANDATORY ESI CONVERSION AND HSA ACTIVATION

(a) Unconditional Hard-Stop Trigger: At 12:01 AM on the first day of Month 19 following enactment—automatically and without discretionary administrative extension or regulatory delay—Phase 2 conversion shall take full legal effect.

(b) The ESI Property Definition: Employer-Sponsored Insurance (ESI) is defined as the total cash amount an employer allocates or pays for an employee's health coverage. It is earned compensation belonging exclusively to the worker.

(c) The 15.3% FICA-Equivalent Extraction: Prior to disbursement to the worker's HSA, 15.3% of the total ESI transfer value shall be deducted directly from the existing benefit transfer pool pursuant to the Internal Revenue Code of 1986 and remitted to the Treasury for the Part B Premium Elimination Fund.

(d) Zero Out-of-Pocket Cost Guarantee: Neither the employer nor the employee shall be assessed any additional out-of-pocket payroll tax beyond the existing ESI transfer amount; no portion of this deduction shall reduce an employee's regular base wages or salary.

(e) Worker Redirection & Tax-Free HSA Deposit: The remaining 84.7% of the ESI transfer pool, plus 100% of the worker's existing paycheck contribution, shall be deposited directly into a personal Health Savings Account (HSA) owned exclusively by the worker. All employer ESI transfers and worker contributions deposited into the personal HSA shall be exempt from Federal, State, and local income taxation.

(f) Dual-Use Consumer Freedom: Funds in the worker's personal HSA are dedicated to healthcare and may be deployed entirely at the worker's individual discretion—either to purchase a Qualified Health Coverage (QHC) insurance policy on the open market or to pay cash directly to providers for any medical procedure, inpatient or outpatient hospital care, surgery, diagnostic testing, imaging, lab work, clinical visit, or prescription based on the worker's personal health needs. Unspent funds remain the permanent property of the worker and roll over year to year without forfeiture.

SECTION 6: THE 1099 SELF-REIMBURSEMENT MANDATE

(a) The Redirection: Because a 1099 independent worker acts as both employer and employee, the 7.65% employer-share of their self-employment tax shall be redirected from the Treasury directly into the worker's personal HSA fund.

(b) Purpose & Parity: These redirected funds may be used to purchase a Qualified Health Coverage (QHC) plan or to pay cash directly for medical expenses, ensuring self-employed workers receive the same tax-free employer healthcare contribution as corporate W-2 workers.

SECTION 7: MEDICARE PART B PREMIUM ELIMINATION FUND & STATUTORY OVERRIDE

(a) Establishment and Purpose: Notwithstanding section 1839 of the Social Security Act (42 U.S.C. 1395r) or any other provision of law, the Secretary of the Treasury is hereby mandated to administer all funds captured via the 15.3% FICA-equivalent extraction in Section 5(c) exclusively to eliminate monthly Medicare Part B premiums for all Part B beneficiaries, setting the beneficiary premium rate to $0.00 nationwide.

(b) Termination of State Buy-In Obligations: Notwithstanding section 1933 of the Social Security Act (42 U.S.C. 1396u-3) or any state-level Medicare Part B premium buy-in agreement or mandatory funding obligation thereunder, all state-level liability for such payments is hereby terminated and rendered null and void upon the implementation of this Act, passing 100% of the captured revenue and savings directly to beneficiaries and state general revenue relief.

(c) Surplus Transfer: Any annual surplus remaining in the Fund after eliminating all Part B premiums shall be transferred directly to the Social Security OASI Trust Fund.

SECTION 8: SOCIAL SECURITY INTEGRITY AND SOLVENCY

(a) Mandatory Savings Redirect: An amount equal to 100% of the certified net savings in annual federal Medicare Part B General Revenue expenditures and reduced federal healthcare outlays resulting from Phase 1 market reforms shall be immediately transferred and dedicated to the Social Security OASI Trust Fund.

(b) Execution Mandate: The Secretary of the Treasury, acting as Managing Trustee of the Social Security Trust Funds, shall calculate these realized federal savings annually and execute the mandatory transfer from the Treasury into the Social Security OASI Trust Fund.

(c) State-Level Fiscal Relief: All savings realized by States through eliminated Medicare Part B buy-in obligations and reduced state-share Medicaid costs resulting from lower market healthcare prices shall remain strictly within the respective state budgets to be utilized at the discretion of each State.

SECTION 9: INSTITUTIONAL COMPLIANCE AND ENFORCEMENT

Any healthcare institution, hospital network, university, or educational entity receiving federal funds that fails to comply with the structural separation, price transparency, or market liberation mandates of this Act shall be penalized as follows: (a) an initial 10% withholding of discretionary federal research and institutional grants upon notice of non-compliance; (b) a 50% suspension of Title IV student financial aid and loan eligibility if non-compliance persists beyond 90 days; and (c) full termination (100%) of Title IV eligibility and federal grant participation if non-compliance reaches 180 days, with eligibility restored immediately upon certification of full compliance by the relevant federal authority.

SECTION 10: SEVERABILITY

If any provision of this Act, or the application thereof to any person or circumstance, is held invalid or unconstitutional, the remainder of this Act and the application of such provision to other persons or circumstances shall not be affected thereby and shall remain in full force and effect.

Prepared by: John Dady

Email: citizensagainsttyranny1776@gmail.com

Websites: iwriteyoushare.com | citizensagainsttyranny.net