S. 5496

Health CARE Act of 2026

Sponsor: Mark R. Warner · 0 cosponsors

Follow this bill

Where it stands

Introduced Sep 24
Committee Now
Senate —
House of Representatives —
Law —

Introduced Sep 24
Committee Now
Senate —
House of Representatives —
Law —

Read twice and referred to the Committee on Finance. (Sep 24)

Votes

No roll-call votes yet.

Official summary

No official summary yet.

Text of the bill

Sec. 1. Short title; table of contents

I Restoring health care and lowering costs

Sec. 101. Repeal of reconciliation health provisions

Sec. 102. Permanent extension of enhanced tax credit

Sec. 103. Promoting consumer outreach and education

II Pathway to universal coverage

Sec. 201. Establishment of health plan

Sec. 202. Availability of plan

Sec. 203. Affordability

Sec. 204. Participating providers

Sec. 205. Provider payment rates

Sec. 206. No effect on Medicare benefits or Medicare trust funds

III Strengthening Medicaid

Sec. 301. Increased FMAP for medical assistance to newly eligible individuals

Sec. 302. Supporting State Medicaid programs through economic downturns

IV Lowering drug costs

Sec. 401. Expanding Medicare Drug price negotiation

Sec. 402. Application of prescription drug inflation rebates to drugs furnished in the commercial market

Sec. 403. Establishing an out-of-pocket limit on expenditures for prescription drugs under group health plans and group and individual health insurance coverage

Sec. 404. Requirements with respect to cost-sharing for insulin products

V Ensuring quality health insurance and removing barriers to care

Sec. 501. Required exceptions process for medication step therapy protocols

Sec. 502. Establishing requirements with respect to the use of prior authorization under Medicare Advantage plans

Sec. 503. Special enrollment period for provider terminations

Sec. 504. Providing coverage for hearing care under the Medicare program

VI Lowering the cost of care

Sec. 601. Strengthening hospital price transparency

Sec. 602. Clinical diagnostic laboratory price transparency

Sec. 603. Imaging services price transparency

Sec. 604. Ambulatory surgical center price transparency

Sec. 605. Strengthening health coverage transparency requirements

Sec. 606. Increasing group health plan access to health data

Sec. 607. Oversight of administrative service providers

Sec. 608. State preemption only in event of conflict

Sec. 609. Requirement for explanation of benefits

Sec. 610. Transparency in billing

Sec. 611. Technical amendments

Sec. 612. Implementation and enforcement funding

VII Reforming PBMs and Protecting Pharmacies

Sec. 701. Ensuring accurate payments to pharmacies under Medicaid

Sec. 702. Preventing the use of abusive spread pricing in Medicaid