This reconciliation bill, the "One Big Beautiful Bill", strongly backed by President Donald Trump, contains a multitude of provisions that increase healthcare freedom. For example, the bill expands consumer-directed coverage: starting January 1, 2026, Obamacare Bronze and Catastrophic plans are treated as HSA-compatible, letting more families pair affordable coverage with tax-advantaged savings. The bill also tightened eligibility and accountability by excluding DACA recipients from exchange subsidies beginning plan year 2026, adding Medicaid "personal accountability" rules for the expansion population (80 hours/month, with rollout late 2026/early 2027), and limiting Essential Health Benefits by excluding gender transition procedures. Furthermore, the bill expanded the orphan drug exclusion so Medicare's "negotiation" regime doesn't penalize medicines that treat multiple rare diseases, and it avoided going further down the road of price controls like a most-favored-nation model. However, the bill missed the chance to deliver meaningful PBM reform.

Support is the Pro-Healthcare Freedom Position for reducing Obamacare Symptoms:

The Sen. Bernie Sanders (D-VT) amendment #2435 to the "One Big Beautiful Bill", expands government control of healthcare by adding a major Medicare benefit expansion and escalating the Inflation Reduction Act drug pricing scheme. On benefits, it adds Medicare coverage for dental, vision, and hearing services beginning January 1, 2028, including routine exams and cleanings, major dental work, dentures, eyeglasses, and hearing aids. On drugs, it worsens the IRA's price control regime by nearly tripling the number of drugs Medicare is required to "negotiate", meaning more medicines are subjected to government extortion backed by massive excise tax style penalties. Secondly, it codifies a Most Favored Nation style price control scheme that pegs U.S. drug prices to a median price in other countries, importing foreign rationing and letting international bureaucracies effectively set what Americans can access. This is a direct attack on medical innovation and patient access by expanding coercive price caps across a far wider share of the drug market.

OPPOSE is the Pro-Healthcare Freedom Position for reducing Obamacare Symptoms:

This bill, the "Medicare for All Act", sponsored by Sen. Bernie Sanders (D-VT), would fully socialize American healthcare by nationalizing health coverage into a single federal program run by HHS. It mandates universal coverage with automatic enrollment and wipes out real private coverage by prohibiting insurance that duplicates government benefits, leaving insurers only a narrow role for supplemental coverage. The bill imposes a one size fits all federal benefits mandate and shifts costs onto taxpayers by banning cost sharing like deductibles and copays for covered services. Its required benefits are sweeping, including long term care, dental and vision, and it explicitly includes abortion and gender affirming care coverage by taxpayers. It also terminates the Obamacare exchanges and consolidates major federal health programs into a centralized government run system, with the federal bureaucracy setting rules for providers and drug coverage, including a federal formulary.

OPPOSE is the Pro-Healthcare Freedom Position for reducing Obamacare Symptoms:

This bill, the "Prescription Drug Price Relief Act of 2025," sponsored by Sen. Bernie Sanders (D-VT), would codify a government price control scheme called "Most-Favored-Nation." It would peg U.S. drug prices to a "median price" in other countries, and if a manufacturer sells a drug above that level, the bill would effectively strip the company's intellectual property protections, allowing others to produce the drug. The bill is an effort to import foreign, government set pricing schemes that rely on heavy handed intervention and socialism to suppress prices. Like other price controls, this approach risks shortages and would seriously undermine medical innovation by scaring off investment and making it harder for manufacturers to recoup the massive costs of research and development, often over $1 billion to bring a drug to market.

Oppose is the Pro-Healthcare Freedom Position for reducing Obamacare Symptoms:

This bill, the "Medicare Dental, Vision, and Hearing Benefit Act of 2025", sponsored by Sen. Angela Alsobrooks (D-MD), expands Medicare by adding new government run coverage for dental, vision, and hearing care. The bill would make Medicare cover routine dental cleanings and exams, basic and major dental services, emergency dental care, and dentures, plus routine eye exams, eyeglasses, and contact lenses, along with routine hearing exams and hearing aids. Instead of empowering patients through choice and competition, this bill represents a major entitlement expansion that grows the government footprint in healthcare and increases pressure for higher spending, higher taxes, and more top-down control over what services are covered and how providers are paid.

OPPOSE is the Pro-Healthcare Freedom Position for reducing Obamacare Symptoms:

This bill, the "Access to Birth Control Act", sponsored by Sen. Cory Booker (D-NJ), creates a new federal mandate on pharmacies by imposing duties to provide FDA approved contraception and related medications. If a requested product is in stock, the pharmacy must provide it without delay. If it is not in stock but the pharmacy ordinarily carries it, the pharmacy must immediately tell the customer and either transfer the prescription or locate a nearby pharmacy that has it, or expedite an order. The bill goes further by policing pharmacy interactions and forcing compliance under threat of lawsuits and penalties, including a private right of action with punitive damages and attorney fees. It also explicitly blocks the Religious Freedom Restoration Act from being used as a defense, thus preventing pharmacists from refusing dispensing on conscience grounds. The bill further increases Washington control over the private operations of pharmacies.

Oppose is the Pro-Healthcare Freedom Position for reducing Obamacare Symptoms:

This bill, the "Equal Access to Abortion Coverage in Health Insurance Act of 2025" or the "EACH Act of 2025", sponsored by Sen. Tammy Duckworth (D-IL), would mandate abortion coverage across a wide range of federally run or taxpayer funded health programs, including Medicaid, CHIP, Medicare, TRICARE, the VA, the Indian Health Service, and the Federal Employees Health Benefits Program. The bill also blocks state and local governments from restricting abortion coverage in private health plans, and it repeals Obamacare's Section 1303, the ACA provision that allowed states to limit abortion coverage in exchange plans and imposed abortion funding segregation rules. It further asserts sweeping federal preemption by declaring the Act supersedes federal law and is not subject to the Religious Freedom Restoration Act.

Oppose is the Pro-Healthcare Freedom Position for reducing Obamacare Symptoms:

This bill, the "Health Care Freedom for Patients Act," sponsored by Sen. Mike Crapo (R-ID), would continue funding the "temporary" enhanced Obamacare subsidies, but it would channel them through health savings accounts (HSAs) instead of sending them directly to insurers. Enrollees earning below 700 percent of the federal poverty level would receive $1,000 if they are 18 to 49 years old and $1,500 if they are 50 to 64 years old. The prospective family of four would receive $5,000. These funds could be used only toward Obamacare Bronze and Catastrophic plans, which typically have higher deductibles and the least generous coverage. While this approach is better than the current enhanced subsidy scheme, which is ripe with waste and fraud and enriches insurers through direct taxpayer-funded payments, rejecting the bill would ensure the expanded Obamacare subsidies end entirely. Members who opposed the bill because they believed the subsidies did not go far enough, were recorded as opposing the pro-healthcare freedom position.

Oppose is the Pro-Healthcare Freedom Position for reducing Obamacare Symptoms:

The Sen. Jeff Merkley (D-OR) amendment #1207 to the budget bill, would establish a slush fund in the FY2025 budget for legislation aimed at "ending price gouging on prescription drugs." While framed as consumer protection, this is the familiar Washington talking point used to justify new federal price caps and expanded government control over drug pricing. In practice, amendments like this are designed to grease the skids for more aggressive Inflation Reduction Act style "negotiation" and other draconian price control policies that punish innovation and reduce long term access to new cures.

Oppose is the Pro-Healthcare Freedom Position for reducing Obamacare Symptoms:

This bill, the "Lower Drug Costs for Families Act", sponsored by Sen. Catherine Cortez Masto (D-NV), worsens the draconian price controls imposed under the Inflation Reduction Act by exporting them beyond Medicare and into the private insurance market. The IRA created an inflation rebate scheme that punishes manufacturers when certain Medicare drug prices rise faster than inflation. This bill applies that same government penalty structure to drugs sold through private health insurance, extending Washington's coercive pricing regime into employer plans and commercial coverage, backed by civil monetary penalties. The bill also makes the price control regime even harsher by resetting the rebate base year from 2021 back to 2016, a change designed to inflate rebate liability and force larger payments to the government. While sold as consumer relief, these policies operate like a backdoor price cap that distorts markets, encourages higher launch prices, reduces discounts, and tightens access as companies try to manage rebate exposure. Over time, this approach undermines investment in new cures and pushes the system further toward centralized government control of medicine.

Oppose is the Pro-Healthcare Freedom Position for reducing Obamacare Symptoms:

This bill, the "Association Health Plans Act", sponsored by Sen. Rand Paul (R-KY), helps restore choice and competition by letting small businesses and self-employed workers band together and be treated as one large employer plan under ERISA. It allows associations to offer coverage even if members are not in the same industry, so long as the group meets basic guardrails like real governance, at least two years of existence, and no health status discrimination. The bill also sets clearer rules for premiums by allowing an actuarially sound base premium built on pooled claims, while permitting employer level contribution rates to reflect each employer's risk profile. It includes protections that bar denying coverage based on a pre-existing condition and bans eligibility rules that discriminate based on health status. Overall, this reform pushes back on Obamacare's one-size fits all small group rules that drive up premiums and limit plan design flexibility for working families and job creators.

Support is the Pro-Healthcare Freedom Position for reducing Obamacare Symptoms:

This bill, the "Personalized Care Act of 2025", sponsored by Sen. Ted Cruz (R-TX), expands health savings accounts by ending the Obamacare restriction that HSAs must be tied only to high-deductible plans. Instead, the bill makes far more Americans eligible to use HSAs, including those covered by typical group or individual coverage, short term plans, certain government coverage like Medicare and Medicaid, and participants in health care sharing ministries. The bill also increases HSA contribution limits, allows HSA funds to be used for more real-world expenses like insurance premiums and direct care fees. Finally, the bill recognizes direct care fees and health care sharing ministry payments as medical care for the unreimbursed medical expense deduction, reinforcing a patient centered path that supports direct doctor patient arrangements instead of funneling everyone through insurer and PBM middlemen.

Support is the Pro-Healthcare Freedom Position for reducing Obamacare Symptoms:

This bill, the "Pharmacy Benefit Manager Transparency Act of 2025", sponsored by Sen. Chuck Grassley (R IA), helps protect patients and taxpayers by implementing safeguards against Pharmacy Benefit Manager schemes that have been fueled by Obamacare market distortions. The bill cracks down on spread pricing by making it unlawful for PBMs to charge a health plan more than the PBM pays the pharmacy for ingredient costs or dispensing fees while keeping the difference. It also restricts certain clawbacks and strengthens transparency by expanding disclosures of PBM fees, price concessions, and manufacturer payments, as well as reporting on formulary changes and steering toward PBM owned pharmacies. The bill largely helps correct the market distortion caused by Obamacare's medical loss ratio (MLR) provision. That mandate helped push insurers to merge with PBMs, and today three vertically integrated firms control roughly 80 percent of the market. This monopolistic structure has enabled PBM schemes that artificially inflate drug costs at the expense of taxpayers and patients.

Support is the Pro-Healthcare Freedom Position for reducing Obamacare Symptoms: