The Great American Healthcare Act Explained

Americans spend more on healthcare than ever, yet many families still struggle with high premiums, deductibles, prescription drug costs, and unexpected medical bills. Rep. Eric Burlison's Great American Healthcare Act is a comprehensive healthcare reform proposal focused on expanding access to Health Savings Accounts, increasing price transparency, encouraging competition, expanding healthcare choices, and giving individuals greater control over how they spend and save their healthcare dollars.

This was initially introduced as H.R. 8324, the Great American Healthcare Plan, in April 2026. Burlison subsequently introduced the Great American Healthcare Act, H.R. 10015, in August 2026, incorporating and expanding key elements of the original proposal.

Healthcare costs have continued to put pressure on American families, workers, and small businesses. Burlison's approach starts with a basic question: Who should control the money being spent on healthcare: patients or institutions?

The Great American Healthcare Act is designed around greater individual control, clearer pricing, more choices, and stronger incentives for competition.

What's in the Act?

1. Health Savings Accounts for Every American

The act would expand access to Health Savings Accounts (HSAs), allowing Americans who are currently unable to use them to establish and contribute to an HSA. The proposal would also substantially increase HSA contribution limits, with the Great American Healthcare Act tying the annual contribution limit to the level available for a 401(k). Under the proposal, HSA dollars could be used for a broader range of qualified healthcare and wellness expenses, including expenses such as:

• Medical care
• Preventive care
• Healthy food
• Vitamins
• Fitness-related expenses
• Other qualifying wellness costs

The goal is to allow Americans to use more of their own healthcare dollars tax-free while building savings for future medical expenses.

Building Healthcare Savings That Stay With You.

The Great American Healthcare Act would also allow families to transfer up to $5,000 tax-free from an HSA into a Trump Account, creating an additional way for families to build long-term savings for the next generation.

2. Real Price Transparency

• Patients often do not know what medical care will actually cost until after they receive it.
• The act would strengthen federal healthcare price-transparency requirements by requiring hospitals and insurers to disclose actual prices in clear, dollar-based terms.
• It would also establish enforcement mechanisms for transparency requirements.
• The objective is straightforward: Patients should be able to know the price before they receive the service.
• With clearer prices, patients can compare providers and make more informed decisions about their care.

3. More Competition and More Healthcare Choices

• The Great American Healthcare Act seeks to increase competition across the healthcare marketplace.
• The legislation would expand access to alternative coverage arrangements and reduce barriers that can limit consumer choice.
• The proposal also includes provisions intended to expand healthcare options and improve access to prescription drugs.
• The underlying approach is to give individuals and families more options rather than relying on a one-size-fits-all model.

4. Prevention and Wellness

• The act would expand the ways Americans can use healthcare dollars for prevention and wellness.
• Rather than limiting tax-advantaged healthcare dollars primarily to treating illness after it occurs, the proposal would allow qualifying funds to be used for certain wellness-related expenses.
• The legislation specifically identifies expenses such as healthy food, vitamins, and fitness-related costs.
• The goal is to give individuals greater flexibility to invest in their health before medical problems become more expensive.

5. Expanding HSA Access Across Coverage Types

• The original Great American Healthcare Act is designed to make HSAs available to Americans who currently cannot contribute to one because of their type of health coverage.
• The proposal specifically addresses Americans enrolled in programs such as Medicare, Medicaid, and ACA coverage, allowing them to establish and contribute to an HSA under the proposed framework.
• The act also addresses Health Care Sharing Ministries by allowing eligible participants to contribute to an HSA, expanding the tax treatment available to people who use those arrangements.

6. A Real Plan to Pay for the Reforms

• The Great American Healthcare Act includes a proposed financing mechanism involving the Federal Reserve's authority to pay interest on reserve balances.
• Under the proposal, the Federal Reserve's broad authority to pay interest on reserve balances would be repealed while preserving a narrower earnings mechanism for supplemental reserves.
• An outside projection from the Foundation for Government Accountability estimates that this change could generate more than $1 trillion over ten years. That projection was subsequently incorporated into the Heritage Foundation's 2026 American Opportunity Agenda.
• The proposal uses those projected savings to offset the cost of its healthcare reforms.

What the Act Means for Patients

The Great American Healthcare Act is built around four central ideas:

• Control: Give Americans greater control over the money they spend on healthcare.
• Transparency: Make healthcare prices easier to see and compare before receiving care.
• Competition: Expand choices and encourage competition among healthcare providers and coverage arrangements.
• Prevention: Allow Americans to use healthcare dollars for qualifying preventive and wellness expenses.

Together, these provisions are intended to move more healthcare decisions and dollars toward the individual.

The Great American Healthcare Act at a Glance

A Patient-First Approach to Healthcare

The Great American Healthcare Act structures the healthcare system around greater individual control, transparent prices, competition, and expanded healthcare choices. The legislation is currently a proposal before Congress. Its provisions, costs, eligibility rules, and implementation may change as the legislative process continues.

Learn More

Read the Great American Healthcare Act → https://www.congress.gov/bill/119th-congress/house-bill/10015

Read the Bill Text → https://www.congress.gov/119/bills/hr10015/BILLS-119hr10015ih.pdf

Read the Great American Healthcare Plan (Initial Proposal-Outdated) → https://www.congress.gov/bill/119th-congress/house-bill/8324