H.R. 8840
Fair Care Act of 2026
Sponsor: Bruce Westerman · 0 cosponsors
Official summary
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Text of the bill
I Modernization of health savings accounts
A Modernization of health savings accounts and contributions
B Assistance to health savings accounts
II Improving Private Health Insurance
A Maintaining Protections for Patients with Preexisting Conditions
B Expanding Coverage Options
C Improving Commercial Health Insurance
III Competition, Transparency and Accountability
A Provider and Insurer Competition
(a) Authorization of appropriations. There is authorized to be appropriated $160,000,000 to the Federal Trade Commission to hire staff to investigate, as consistent with the Sherman Antitrust Act and other relevant Federal laws, anti-competitive mergers and practices under such laws to the extent such mergers and practices relate to providers of inpatient and outpatient health care services, as defined by the Secretary of Health and Human Services.
(b) Medicare Advantage rates applied to certain HHI hospitals
(1) In general. Section 1866(a) of the Social Security Act (42 U.S.C. 1395cc(a)) is amended—
(A) in paragraph (1)—
(i) in subparagraph (X), by striking and at the end;
(ii) in subparagraph (Y), by striking the period at the end and inserting ; and; and
(iii) by inserting after subparagraph (Y) the following new subparagraph:
(Z) subject to paragraph (4), beginning in 2028, in the case of a hospital located in a county whose population density is above the median population density for all counties in the United States with respect to which there is a Herfindahl-Hirschman Index (HHI) of greater than 4,000, to apply the average reimbursement rate (or, with respect to years before 2032, the percent specified in paragraph (4)(C) of such average rate) with respect to individuals (regardless of whether such an individual is entitled to or eligible for benefits under this title, but excluding individuals eligible for medical assistance under a State plan under title XIX) furnished items and services at such hospital that would be billable under this title for such items and services if furnished by such hospital to an individual enrolled under part C.
; and
(B) by adding at the end the following new paragraph:
(4)
(A) The requirement under paragraph (1)(Z) shall not apply in the case of a hospital in a hospital referral region if—
(i) the HRR market share of such hospital (as determined under subparagraph (B)) is less than 0.15; or
(ii) the hospital is located in a rural area (as defined in section 1886(d)(2)(D)).
(B) For purposes of subparagraph (A), the HRR market share of a hospital in a hospital referral region is equal to—
(i) the total revenue of the hospital, divided by
(ii) the total revenue of all hospitals in the hospital referral region.
(C) For purposes of paragraph (1)(Z), the percent specified in this subparagraph is—
(i) for 2028, 178 percent;
(ii) for 2029, 150 percent;
(iii) for 2030, 130 percent; and
(iv) for 2031, 110 percent.
(2) Effective date. The amendments made by this subsection shall apply with respect to items and services furnished on or after January 1, 2026.
(c) Grants for hospital infrastructure improvement
(1) In general. The Secretary of Health and Human Services shall carry out a grant program under which the Secretary shall provide grants to eligible States, in accordance with this subsection.
(2) Uses. An eligible State receiving a grant under this subsection may use such grant to improve the State hospital infrastructure and to supplement any other funds provided for a purpose authorized under a State or local hospital grant program under State law.
(3) Eligibility
(A) In general. An eligible State may receive not more than one grant under this subsection with respect to each qualifying criterion described in subparagraph (B) that is met by the State.
(B) Eligible State. For purposes of this subsection, the term eligible State means a State that meets any one or more of the following qualifying criteria:
(i) The State does not have in effect any State certificate of need law that requires a health care provider to provide to a regulatory body a certification that the community needs the services provided by the health care provider.
(ii) The State has in effect State scope of practice laws that—
(I) allow advanced practice providers (such as nurse practitioners, advanced practice registered nurses, clinical nurse specialists, and physician assistants) to evaluate patients; diagnose, order, and interpret diagnostic tests; and initiate and manage treatments; or
(II) provide that the only justification for limiting the scope of practice of a health care provider is safety to the public.
(iii) The State does not have in effect any State laws that require managed care plans to accept into the network of such plan any qualified provider who is willing to accept the terms and conditions of the managed care plan.
(iv) The State does not have in effect any Certificate of Public Advantage laws that clearly articulate the State’s intent to displace competition in favor of regulation or that violate State or Federal antitrust laws.
(v) The State does not have in effect any network adequacy laws regulating a health plan’s ability to deliver benefits by providing reasonable access to a sufficient number of in-network primary care and specialty physicians, as well as all health care services included under the terms of an insuree’s contract with a health insurer.
(4) Funding. There is authorized to be appropriated to carry out this subsection $1,000,000,000 for each of the fiscal years 2026 through 2035. Funds appropriated under this paragraph shall remain available until expended.
(d) Critical access hospital reimbursement rates
(1) Part A. Section 1814(l)(1) of the Social Security Act (42 U.S.C. 1395f(l)(1)) is amended by inserting (or, for 2026, 102, plus 1 percentage point for each subsequent year through 2033, and 110 for each subsequent year thereafter) after 101.
(2) Part B. Section 1834(g)(1) of such Act (42 U.S.C. 1395m(g)(1)) is amended by inserting (or, for 2026, 102, plus 1 percentage point for each subsequent year through 2033, and 110 for each subsequent year thereafter) after 101.
B Price Transparency
C Prescription Drug Competition and Innovation
D Prescription Drug and Pharmacy Benefit Manager Transparency
E Medicare and Medicaid Prescription Drug Reforms
F Medical Malpractice Reform
IV Medicare and Medicaid Reforms
A Medicaid Reforms
B Medicare Reforms
C Medicare Choice and Competition
D Telehealth Improvements and Expansion