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 "Ensuring Lasting Smiles Act", sponsored by Sen. Tammy Baldwin (D-WI), expands Obamacare style federal benefit mandates by requiring group and individual health plans to cover outpatient and inpatient items and services for congenital anomalies or birth defects that affect the eyes, ears, teeth, mouth, or jaw. It compels plans to cover reconstructive treatment and broad related services deemed medically necessary by a treating physician, including adjunctive dental, orthodontic, and prosthodontic care from birth through completion of treatment, even when plans otherwise exclude these categories. This is another top down coverage mandate that overrides benefit design, drives higher premiums, and pushes insurers toward narrower networks and more utilization controls to manage costs. Instead of empowering patient choice and competition, it forces a one size fits all standard that grows federal control and worsens the Obamacare playbook of mandated benefits.

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:

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 "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 "SMART Prices Act", sponsored by Sen. Amy Klobuchar (D-MN), expands the scope of the draconian price controls imposed under the Inflation Reduction Act. The IRA authorized Medicare to impose so called "maximum fair prices" on selected drugs and backed that scheme with massive excise tax style penalties that can escalate to coercive levels. The bill would more than triple the number of drugs Medicare is required to "negotiate", while also shortening the weight time following market approval that negotiation may begin (from up to 11 years, to just 3 years). This measure further threatens medical innovation under the IRA's extortion style approach. Such policies make investment harder to justify given the enormous cost of bringing a drug to market, often over $1 billion, plus the many failed candidates along the way. If the government steps in too early, imposes below market prices, and denies companies a fair chance to recover costs, fewer breakthroughs will be funded and patients will ultimately pay the price in delayed or lost cures.

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 "340B PATIENTS Act of 2025", sponsored by Sen. Peter Welch (D-VT) would codify and expand the rampant abuse of the 340B drug pricing program that accelerated after Obamacare. The 340B program strong-arms drug manufacturers into providing steep discounts to "safety-net" providers as a condition of participating in Medicaid and other federal reimbursements. Under this bill, manufacturers would be forced to provide 340B pricing to contract pharmacies regardless of how or where a drug is dispensed, and the bill would impose draconian penalties for noncompliance. By letting hospitals route prescriptions through vast contract-pharmacy networks, the bill would supercharge the "buy low, bill high" model far beyond the walls of a true safety-net facility. This enrichment has exploded since Obamacare: there were 503 contract pharmacies in 2010, and now there are 34,840, with the scheme estimated to generate more than $53 billion in discounts. The predictable result is higher drug costs and less innovation for patients, all to enrich select hospital systems rather than the vulnerable people the program was supposedly meant to serve.

Oppose 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:

This bill, the "Safe and Affordable Drugs from Canada Act of 2025", sponsored by Sen. Amy Klobuchar (D-MN), forces the FDA to create a pathway for individuals to import certain prescription drugs from Canada for personal use. It allows up to a 90-day supply purchased from an FDA approved Canadian pharmacy, filled with a valid US physician prescription, and matching an FDA approved drug's active ingredient and form. While marketed as relief, this approach effectively leans on Canada's government-controlled pricing system and imports the logic of foreign price caps into the US market. It does not fix the real drivers of high drug costs like PBM spread pricing and rebate games, and it risks undermining innovation by normalizing reliance on countries that free ride off American research and development. Over time, that means fewer breakthroughs and fewer competitive options for patients.

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