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Thomas H. Kean Jr. — Republican U.S. Representative for New Jersey's 7th Congressional District (official headshot)

Thomas H. Kean Jr. Voting Record & Scorecard | Center for Healthcare Affordability

US Representative from NJ

District: 7 • Republican

2025 Score:

64.91%

Thomas H. Kean Jr. Scorecard Summary

Current rating
65%
Substantive votes
11 of 35 in 2025
District grade
B+
View Member History

Lifetime Ratings by Policy Category

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Rep. Thomas H. Kean Jr. (R-NJ-7) earned a 65% Center for Healthcare Affordability score for 2025, showing moderate alignment with healthcare reform and limited-government healthcare positions. Thomas H. Kean Jr. voted on 11 of the 35 substantive bills scored by Reform Healthcare in 2025. Highest category scores: Stagnating Advancements in Healthcare (100%), Skyrocketing Insurance Premiums (100%), and Exploding Government Spending (38%). Thomas H. Kean Jr. represents New Jersey's 7th Congressional District in the U.S. House of Representatives.

Healthcare Policy

Lawmaker Position

H.Con.Res. 58House 2025

Denouncing Socialism and Rejecting the Ideology Behind Government Controlled Healthcare.

+2
FOR
Affordable Healthcare
This concurrent resolution, "Denouncing the horrors of socialism," sponsored by Rep. Maria Elvira Salazar (R-FL), condemns socialist ideology and highlights the real-world human suffering it has caused. In healthcare, socialism means government control replacing patient choice, with bureaucrats setting rules, restricting options, and pushing toward one size fits all systems like single payer. The resolution reinforces a clear warning that centralized power leads to rationing, weaker medical innovation, and a diminished doctor-patient relationship.
Support is the Pro-Healthcare Freedom Position for reducing Obamacare Symptoms:
Exploding Government Spending and Welfare Entrapment.
H.R. 1House 2025

Passing a "Big Beautiful Bill" with Multiple Pro-Freedom Healthcare Reforms.

+5
FOR
Affordable Healthcare
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:
Skyrocketing Insurance Premiums.
H.R. 1492House 2025

Reducing the Scope of the Draconian Price Controls Imposed on Pharmaceuticals Under the Inflation Reduction Act.

+6
FOR
Affordable Healthcare
This bill, sponsored by Rep. Greg Murphy, helps reduce 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. This bill would require that a drug have at least 7 years of market approval (for small molecule drugs) or 11 years (for biologics) before it can be targeted for negotiation. This reform is critical to protecting continued medical innovation after the IRA's extortion style approach, which makes 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.
Support is the Pro-Healthcare Freedom Position for reducing Obamacare Symptoms:
Rapidly Rising Pharmaceutical Costs and Lower Innovation
H.R. 1672House 2025

Protecting Genetic Drug Innovation from the Inflation Reduction Act's Draconian Price Controls.

+5
FOR
Affordable Healthcare
This bill, the "Maintaining Investments in New Innovation Act", sponsored by Rep. Don Davis (D-NC), narrows the reach of the Inflation Reduction Act's draconian price controls by protecting genetically targeted drug technologies from being pulled too quickly into Medicare's so called "negotiation" regime. The IRA directs Medicare to impose government set "maximum fair prices" on selected drugs and backs that system with coercive penalty threats that function like excise tax style enforcement. The bill responds to the reality that genetically targeted medicines often take longer and cost more to develop, frequently serving smaller patient populations and requiring specialized research and manufacturing. The bill requires these genetically targeted drug products to be on the market for at least 11 years before they can be selected for Medicare negotiation, giving innovators a better chance to recover investment and sustain continued development of breakthrough cures.
Support is the Pro-Healthcare Freedom Position for reducing Obamacare Symptoms:
Rapidly Rising Pharmaceutical Costs and Lower Innovation
H.R. 1834House 2025

Socializing the Cost of the Obamacare Catastrophe Extending the Enhanced Subsidies through 2028 at a Cost of $350 Billion

-9
AGAINST
Affordable Healthcare
The "Breaking the Gridlock Act", sponsored by Rep. James McGovern (D-MA) would continue fully funding all the "temporary" enhanced Obamacare subsidies for an additional three years, through the end of 2028. These COVID era subsidy boosts, created in 2021 and later extended by the Inflation Reduction Act only through 2025, removed the 400 percent of the federal poverty level cap on eligibility, allowing situations in which families earning up to $600,000 can receive taxpayer funded subsidies. The program is also rife with fraud and waste, and insurers have been enriched because the enhanced subsidies are effectively paid directly to them. Overall, these enhanced subsidies are projected to add roughly $350 billion to the national debt, on top of the enormous costs of the underlying Obamacare subsidy system. Oppose is the Pro Healthcare Freedom Position for reducing Obamacare Symptoms: Exploding Government Spending and Welfare Entrapment
H.R. 1968House 2025

Enacting an HHS Funding Bill that Fuels Obamacare and Extends Runaway Medicaid Spending and Hospital Subsidies

-3
AGAINST
Affordable Healthcare
This bill, the “Full-Year Continuing Appropriations and Extensions Act, 2025,” keeps HHS funded for the rest of FY2025 on essentially last year’s levels (despite the DOGE cuts) and continues Obamacare-era healthcare policy on autopilot. Instead of using a must-pass funding deadline to demand reforms that lower costs and expand choice, this bill extends the same Washington-driven system that keeps patients trapped and taxpayers on the hook. Most notably, the bill does not rein in Medicaid’s runaway cost trajectory, and it further delays scheduled reductions to Medicaid hospital subsidies known as DSH payments. Those cuts were supposed to start tightening the belt, but the bill pushed them off again, protecting a crony flow of taxpayer dollars to politically powerful hospital systems. Even with all the talk about DOGE and cost cutting, this bill delivered no real reform, helped lock in higher federal healthcare spending, and kept deficit spending rolling. Note: lawmakers who opposed the bill merely because it didn't further hike spending were also recorded as opposing.
Oppose is the Pro-Healthcare Freedom Position for failing to reduce Obamacare Symptoms:
Exploding Government Spending and Welfare Entrapment.
H.R. 498House 2025

Preventing Abuse of Medicaid Healthcare Resources by Banning Usage on Gender Transitions for Minors.

+4
FOR
Affordable Healthcare
This bill, the "Do No Harm in Medicaid Act", sponsored by Rep. Dan Crenshaw (R-TX), helps reduce abuse of the Medicaid welfare system by preventing taxpayer funded healthcare resources from being used for elective gender transition interventions for minors. The bill prohibits federal Medicaid payments for specified gender transition procedures for anyone under age 18, including surgeries, cross sex hormones, and puberty blockers. By drawing a clear boundary on what taxpayers should be forced to fund, the bill protects children from irreversible medicalization and keeps Medicaid focused on legitimate medical care rather than ideological medicine.
Support is the Pro-Healthcare Freedom Position for reducing Obamacare Symptoms:
Exploding Government Spending and Welfare Entrapment.
H.R. 6703House 2025

Improving PBM Transparency and Increasing Choice in Healthcare through Expanded Association Health Plans.

+5
FOR
Affordable Healthcare
This bill, the "Lower Health Care Premiums for All Americans Act", sponsored by Rep. Mariannette Miller Meeks (R-IA), helps restore choice and competition in healthcare by rolling back key Obamacare era barriers that keep coverage expensive and rigid. Most notably, it expands Association Health Plans so small businesses and independent workers can band together for better rates, instead of being trapped in the one size fits all ACA framework. The bill also strengthens consumer control by expanding employer flexibility through CHOICE arrangements, allowing employers to set aside pre-tax dollars so employees can buy the coverage they prefer, including in the individual market. Finally, it targets Pharmacy Benefit Manager schemes by increasing transparency requirements and ensuring plans can access the data needed to expose spread pricing and rebate games that inflate prescription costs.
Support is the Pro-Healthcare Freedom Position for reducing Obamacare Symptoms:
Skyrocketing Insurance Premiums.
H.R. 7148House 2025

Enacting Significant PBM Reform in the Consolidated Appropriations Act, 2026

+4
FOR
Affordable Healthcare
This bill, the “Consolidated Appropriations Act, 2026,” sponsored by Rep. Tom Cole (R OK), enacted targeted Pharmacy Benefit Manager reforms aimed at lowering prescription drug costs and improving transparency. It bars PBMs in Medicare Part D from tying their compensation to a drug’s list price, restricts spread pricing, and strengthens reporting and disclosure rules so plans, employers, and regulators can better see how PBMs are paid and how rebates and fees affect what patients and taxpayers ultimately spend. The bill largely helps correct the market distortion caused by Obamacare’s medical loss ratio 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: Rapidly Rising Pharmaceutical Costs and Lower Innovation.
H. Res. 780 (Discharge)House 2025

Fueling the Out-of-Control Growth of Obamacare by Advancing a Discharge Petition to Extend the Enhanced Subsidies through 2028 at a Cost of $350 Billion

-8
AGAINST
Affordable Healthcare
This motion officially advances H.Res. 780, the discharge petition vehicle used to bring H.R. 1834 to the floor. The vote would advance the continued funding of the temporary enhanced Obamacare subsidies for an additional three years, through the end of 2028. These COVID era subsidy boosts, created in 2021 and later extended by the Inflation Reduction Act only through 2025, removed the 400 percent of the federal poverty level cap on eligibility, allowing situations in which families earning up to $600,000 can receive taxpayer funded subsidies. The program is also rife with fraud and waste, and insurers have been enriched because the enhanced subsidies are effectively paid directly to them. Overall, these enhanced subsidies are projected to add roughly $350 billion to the national debt, on top of the enormous costs of the underlying Obamacare subsidy system. Oppose is the Pro Healthcare Freedom Position for reducing Obamacare Symptoms: Exploding Government Spending and Welfare Entrapment
H. Res. 953House 2025

Advancing Conservative Healthcare Reforms Without the Revival of Expanded Obamacare Subsidies.

+6
FOR
Affordable Healthcare
This procedural motion via H.Res. 953, sets the House up to vote on a slate of conservative healthcare reforms and, importantly, does not revive the "temporary" Obamacare subsidy expansion that expired December 31, 2025. Those COVID-era subsidy boosts, created in 2021 and later extended by the Inflation Reduction Act only through 2025, removed the 400% federal poverty level cap for subsides. Under the "temporary" expansion, some families earning as much as $600,000 annually were receiving taxpayer-funded subsidies. Additionally, health insurers (paid directly from the government) had become enriched through the rampant fraud and waste within the system.
Support is the Pro-Healthcare Freedom Position for reducing Obamacare Symptoms:
Exploding Government Spending and Welfare Entrapment.
H.J.Res. 123House 2025

Preserving Obamacare Subsidy Abuse by Blocking Marketplace Integrity Reforms.

Neutral
This joint resolution, sponsored by Rep. Emilia Strong Sykes (D-OH), uses the Congressional Review Act to nullify the Trump Administration CMS's "Marketplace Integrity and Affordability" rule, a package of reforms aimed at reducing improper Obamacare enrollments and tightening subsidy accountability. The underlying rule strengthened income verification, tightened eligibility redeterminations, and targeted the broker and enrollment channel abuses that have fueled waste, fraud, and people being placed into coverage without real consent. The resolution would erase key guardrails that protect taxpayers and honest enrollees, including restoring looser rules that allowed more zero premium enrollments to be exploited, reversing policies that remove DACA recipients from subsidized exchange eligibility, and rolling back limits that prevented gender transition procedures from being treated as an Essential Health Benefit in ACA plans. Instead of fixing Obamacare's broken subsidy pipeline, this resolution protects it.
Oppose is the Pro-Healthcare Freedom Position for reducing Obamacare Symptoms:
Exploding Government Spending and Welfare Entrapment.
H.R. 114House 2025

Repealing Obamacare and Restoring Patient Choice through a Full ACA Repeal.

Neutral
This bill, the "Responsible Path to Full Obamacare Repeal Act", sponsored by Rep. Andy Biggs (R-AZ), fully repeals the Affordable Care Act and the 2010 reconciliation law, with the repeal taking effect at the beginning of fiscal year 2026. It also restores the provisions of law that Obamacare rewrote, reversing the command-and-control structure that drove higher premiums, narrower networks, and federal micromanagement of coverage. Unlike half measures that keep Obamacare's regulatory spine in place, this is a clean repeal that clears the deck for real patient centered reforms like consumer directed coverage, competition across state lines, and targeted help for the truly vulnerable without trapping families in subsidized government managed insurance.
Support is the Pro-Healthcare Freedom Position for reducing Obamacare Symptoms:
Exploding Government Spending and Welfare Entrapment.
H.R. 2045House 2025

Expanding Medicare into a Bigger Government Run Benefit Program for Dental, Vision, and Hearing.

Neutral
This bill, the "Medicare Dental, Vision, and Hearing Benefit Act of 2025", sponsored by Rep. Lloyd Doggett (D-TX), 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:
Exploding Government Spending and Welfare Entrapment.
H.R. 2191House 2025

Expanding Rural Access to Care by Reversing Obamacare Restrictions on Physician Owned Hospitals.

Neutral
This bill, the "Physician Led and Rural Access to Quality Care Act", sponsored by Rep. Morgan Griffith (R-VA), helps expand access to care in rural communities by rolling back Obamacare era restrictions that blocked new physician owned hospitals and prohibited existing facilities from expanding. The bill revises the federal physician self-referral rules so a covered rural hospital can qualify for an exemption, and it ends the blanket federal expansion prohibition that has locked in hospital monopolies and protected entrenched systems from competition. By allowing physician-led facilities to open and grow in rural areas, the bill promotes competition, increases local capacity, and gives patients more options instead of forcing communities to rely on consolidated hospital chains. This approach helps address the supply shortage and access crisis that has worsened under government-driven market distortions.
Support is the Pro-Healthcare Freedom Position for reducing Obamacare Symptoms:
Higher Hospital and Provider Costs With Less Price Transparency.
H.R. 2528House 2025

Lowering Premiums by Expanding Association Health Plans and Limiting Obamacare Small Group Mandates.

Neutral
This bill, the "Association Health Plans Act", sponsored by Rep. Tim Walberg (R-MI), 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:
Skyrocketing Insurance Premiums
H.R. 2544House 2025

Growing the Government Takeover of Healthcare by Expanding the IRA's Rebate Mandates to Include the Private Sector.

Neutral
This bill, the "Lower Drug Costs for Families Act", sponsored by Rep. Steven Horsford (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:
Rapidly Rising Pharmaceutical Costs and Lower Innovation
H.R. 2553House 2025

Hiking Insurance Premiums by Imposing a Federal Cap on Prescription Drug Cost Sharing.

Neutral
This bill, the "Capping Prescription Costs Act of 2025", sponsored by Rep. Steven Horsford (D-NV), imposes a new federal cap on what patients can be charged out of pocket for prescription drugs, not just in Obamacare plans but across employer coverage as well. Starting in plan year 2026, it caps annual prescription drug cost sharing at $2,000 per individual and $4,000 per family, with the cap increased in later years based on medical inflation. While marketed as relief, this measure merely worsens Obamacare's coverage mandates, shifting costs instead of fixing the real drivers of high drug prices. When government caps cost sharing, insurers and employers offset it through higher premiums, tighter formularies, more prior authorization, and less choice for patients.
Oppose is the Pro-Healthcare Freedom Position for reducing Obamacare Symptoms:
Skyrocketing Insurance Premiums
H.R. 3069House 2025

Fully Socializing the Healthcare System through "Medicare for All".

Neutral
This bill, the "Medicare for All Act", sponsored by Rep. Primila Jayapal (D-WA), 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:
Exploding Government Spending and Welfare Entrapment.
H.R. 3162House 2025

Importing Foreign Price Controls by Expanding Prescription Drug Importation from Countries with Socialist Pricing Schemes.

Neutral
This bill, the "Affordable and Safe Prescription Drug Importation Act of 2025", sponsored by Rep. Janice Schakowsky (D-IL), amends federal law to legalize large scale prescription drug importation by wholesale distributors, pharmacies, and individuals. It directs HHS to issue regulations within one year to stand up an importation pipeline built around certified foreign sellers and qualifying drugs marketed in Canada, the United Kingdom, the European Union, and Switzerland, with authority to expand to additional countries later. For individuals, the bill explicitly authorizes personal importation including from online foreign pharmacies, up to a 90-day supply, so long as the buyer has a valid US prescription. While marketed as savings, this approach effectively leans on other countries' government-controlled pricing systems and normalizes importing foreign price controls into the US market. It also fails to fix the real drivers of high drug costs at home such as PBM spread pricing and rebate games, while risking long term damage to innovation by further letting foreign governments free ride on American research and development.
Oppose is the Pro-Healthcare Freedom Position for reducing Obamacare Symptoms:
Rapidly Rising Pharmaceutical Costs and Lower Innovation.
H.R. 3277House 2025

Worsening Obamacare Mandates by Forcing Coverage of Additional Conditions.

Neutral
This bill, the "Ensuring Lasting Smiles Act", sponsored by Rep. Neal Dunn (R-FL), 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:
Skyrocketing Insurance Premiums.
H.R. 3546House 2025

Codifying a Socialist Drug Pricing Scheme Referred to as "Most-Favored-Nation".

Neutral
This bill, the "Prescription Drug Price Relief Act of 2025," sponsored by Rep. Ro Khanna (D-CA), 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:
Rapidly Rising Pharmaceutical Costs and Lower Innovation
H.R. 4002House 2025

Restoring Competition by Repealing Obamacare's Ban on New and Expanded Physician Owned.

Neutral
This bill, the "Patient Access to Higher Quality Health Care Act of 2025", sponsored by Rep. Beth Van Duyne (R-TX), rolls back Obamacare era restrictions that effectively banned new physician owned hospitals and blocked existing facilities from expanding if they participate in Medicare. It repeals the ACA changes tied to the Stark law whole hospital exception, reopening a path for physician led hospitals to form and grow without Washington protecting incumbent hospital systems from competition. Obamacare's restrictions helped entrench consolidated hospital monopolies, limiting patient choice and keeping prices high by choking off new entrants. Allowing physician owned hospitals to expand can increase capacity, improve quality through specialization, and give patients an alternative to dominant health systems that too often face no real competitive pressure.
Support is the Pro-Healthcare Freedom Position for reducing Obamacare Symptoms:
Higher Hospital and Provider Costs With Less Price Transparency.
H.R. 4074House 2025

Advancing the Growth of the Medicaid Welfare System through Additional Federal Guidance.

Neutral
This bill, the "Optimizing Postpartum Outcomes Act of 2025", sponsored by Rep. Don Bacon (R-NE), directs the Centers for Medicare and Medicaid Services to issue guidance to states to support coverage of prenatal and postpartum pelvic health services under Medicaid and CHIP. It also requires a GAO study on gaps in Medicaid coverage for postpartum women, and directs the CDC to educate health professionals and postpartum women on pelvic health services. While postpartum care matters, this approach leans further into taxpayer funded programs and federal direction rather than patient-driven reforms that expand choice and consumer control. Guidance from Washington often becomes the groundwork for new mandates and higher spending, pushing states toward broader Medicaid benefit expectations instead of addressing affordability through market competition and consumer-directed care.
Oppose is the Pro-Healthcare Freedom Position for reducing Obamacare Symptoms:
Exploding Government Spending and Welfare Entrapment;
H.R. 4084House 2025

Worsening Obamacare Style Mandates by Forcing Pharmacy Dispensing and Infringing Religious Freedom Protections.

Neutral
This bill, the "Access to Birth Control Act", sponsored by Rep. Robin Kelly (D-IL), 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:
Shrinking Competition and Fewer Quality Care Options
H.R. 4317House 2025

Lowering Drug Costs by Combating PBM Schemes Caused by Obamacare.

Neutral
This bill, the "Pharmacy Benefit Manager Reform Act of 2025" or the "PBM Reform Act of 2025", sponsored by Rep. Buddy Carter (R-GA), helps protect patients and taxpayers by implementing safeguards against Pharmacy Benefit Manager schemes that have been fueled by Obamacare's market distortions. Under the bill, PBMs that contract with the government to administer Medicare services could receive compensation only through flat dollar service fees, not as a percentage of drug prices or manufacturer rebates. The bill also prohibits "spread pricing," in which PBMs charge plans more for ingredient costs or dispensing fees than the PBM actually pays pharmacies. Finally, it strengthens transparency by expanding reporting requirements related to formulary pricing practices and PBM fee structures. The bill largely helps correct the market distortion caused by Obamacare's medical loss ratio 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:
Rapidly Rising Pharmaceutical Costs and Lower Innovation
H.R. 4406House 2025

Socializing Healthcare at the State Level through a Universal Coverage Waiver of Medicare, Medicaid, and Employer Plans.

Neutral
This bill, the "State Based Universal Health Care Act of 2025", sponsored by Rep. Ro Khanna (D-CA), creates a new Obamacare waiver that lets states build a state-run universal health care system starting in 2026 by waiving major federal healthcare laws and funding streams. It explicitly allows waiver of key ACA coverage rules and subsidies, plus Medicare, Medicaid, CHIP, FEHBP, TRICARE, and even ERISA preemption, meaning states could pull employer coverage into a government designed system and redirect federal health dollars into a single state-controlled plan. The bill pushes centralized benefits mandates as a condition of approval, including required coverage for abortion, contraception, and gender affirming care, and it defines eligible "residents" to include aliens lawfully residing in the state, including those granted deferred action. It requires a plan to reach at least 95 percent coverage within five years and claims budget neutrality, but in reality it is a blueprint for expanding government control over healthcare decisions, costs, and coverage design at the state level.
Oppose is the Pro-Healthcare Freedom Position for reducing Obamacare Symptoms:
Exploding Government Spending and Welfare Entrapment.
H.R. 4581House 2025

Worsening the Cronyism Fueled by Obamacare Within the 340B Program.

Neutral
This bill, the "340B PATIENTS Act of 2025", sponsored by Rep. Doris Matsui (D-CA) 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:
Rapidly Rising Pharmaceutical Costs and Lower Innovation
H.R. 4606House 2025

Worsening Obamacare Coverage Mandates by Forcing Plans to Cover Hearing Devices.

Neutral
This bill, the "Ally's Act", sponsored by Rep. Joe Neguse (D-CO), imposes a new Obamacare style federal coverage mandate on private health insurance by requiring group and individual plans to cover auditory implant devices, including bone conduction implants and cochlear implants, plus external sound processors. The mandate goes far beyond basic coverage by requiring maintenance, repairs, adhesive adapters and headbands, comprehensive hearing assessments, surgery, postoperative visits, and aural rehabilitation services, along with device upgrades or replacements every 5 years. The bill also restricts insurers from using normal benefit design and utilization management by requiring cost sharing and treatment limits that are no more restrictive than medical and surgical benefits, and by prohibiting plans from denying or limiting coverage when a physician or qualified audiologist deems the item or service medically necessary. It even reaches into Obamacare's grandfathered plan framework, further eroding the limited flexibility that still exists outside the ACA mandate structure.
Oppose is the Pro-Healthcare Freedom Position for reducing Obamacare Symptoms:
Skyrocketing Insurance Premiums.
H.R. 4611House 2025

Worsening Obamacare Coverage Mandates by Forcing Plans to Cover Abortion.

Neutral
This bill, the "Equal Access to Abortion Coverage in Health Insurance Act of 2025" or the "EACH Act of 2025", sponsored by Rep. Ayanna Pressley (D-MA), 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:
Skyrocketing Insurance Premiums.
H.R. 5582House 2025

Restoring Market Forces to Healthcare by Strengthening "Price Transparency".

Neutral
This bill, the "Patients Deserve Price Tags Act", sponsored by Rep. John James (R-MI), strengthens price transparency so patients can see real prices before they get care, instead of being trapped by hidden rates and surprise bills. The bill requires hospitals to publish all standard charges and negotiated prices in a clear format and expands the transparency framework to additional settings like imaging services and ambulatory surgery centers. The bill also forces insurers and health plans to give consumers clearer cost information and requires more meaningful explanation of benefits, including itemized descriptions and billing codes so patients can understand what was charged and what they owe. It further pushes back on health insurer and pharmacy benefit manager secrecy by protecting employer access to claims and payment data that is often buried.
Support is the Pro-Healthcare Freedom Position for reducing Obamacare Symptoms:
Higher Hospital and Provider Costs With Less Price Transparency.
H.R. 608House 2025

Fueling Obamacare Expansion by Letting Cities Bypass States and Directly Expand Medicaid.

Neutral
This bill, the "COVER Now Act", sponsored by Rep. Lloyd Doggett (D-TX), creates a new Medicaid demonstration program that lets counties and cities in non-expansion states enroll the Obamacare Medicaid expansion population directly, even if the state government has rejected expansion. It waives core Medicaid structure rules so Washington can treat local governments like mini states for Medicaid purposes, and it offers a 100 percent federal match for the first three years, using taxpayer dollars to pressure localities into building a new entitlement pipeline. The bill also blocks states from stopping these local Medicaid expansions and threatens funding penalties if states push back. This is federal overreach that expands dependency and government run care while bypassing state accountability. Instead of patient centered reforms that lower premiums and expand private options, it doubles down on Obamacare's welfare expansion model and further centralizes healthcare decisions in Washington.
Oppose is the Pro-Healthcare Freedom Position for reducing Obamacare Symptoms:
Exploding Government Spending and Welfare Entrapment.
H.R. 6166House 2025

Threatening Innovation through a Series of New Pharmaceutical Price Controls Schemes and Insurance Mandates.

Neutral
This bill, the "Lowering Drug Costs for American Families Act", sponsored by Rep. Frank Pallone (D-NJ) contains a multitude of draconian price control provisions that threaten innovation in the pharmaceutical sector. Firstly, the bill would nearly triple the number of drugs Medicare is required to "negotiate" (government extortion backed by massive excise tax style penalties). Secondly, the bill would codify a "Most-Favored-Nation" price control scheme that pegs U.S. drug prices to a "median price" in other countries. Thirdly, the bill contains provisions that prevent drug manufactures from raising prices greater than the rate of inflation, along with a host of price controls on out-of-pocket expenses for drugs in insurance plans. This measure further threatens medical innovation. 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:
Rapidly Rising Pharmaceutical Costs and Lower Innovation
H.R. 6609House 2025

Lowering Drug Costs by Combating PBM Spread Pricing Schemes in Medicare and Medicaid.

Neutral
This bill, the "Pharmacists Fight Back in Medicare and Medicaid Act", sponsored by Rep. Jake Auchincloss (D-MA), helps protect patients and taxpayers by cracking down on Pharmacy Benefit Manager schemes in Medicare Part D, Medicare Advantage drug coverage, and Medicaid managed care. The bill targets spread pricing by requiring pharmacy reimbursement to be benchmarked to the national average drug acquisition cost and a fair dispensing fee, instead of PBM manipulated pricing that overcharges plans while underpaying pharmacies. The bill also restricts PBM steering that funnels patients into PBM owned pharmacies, and it requires rebate pass through rules so PBMs cannot hoard manufacturer payments while patients face inflated prices at the counter. These reforms push back on the consolidated PBM middleman model that has been fueled by Obamacare market distortions and has artificially inflated prescription costs while driving independent pharmacies out of business.
Support is the Pro-Healthcare Freedom Position for reducing Obamacare Symptoms:
Rapidly Rising Pharmaceutical Costs and Lower Innovation.
H.R. 810House 2025

Restoring Healthcare Freedom by Expanding HSAs and Empowering Direct Care.

Neutral
This bill, the "Personalized Care Act of 2025", sponsored by Rep. Chip Roy (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:
Skyrocketing Insurance Premiums

Frequently Asked Questions

What is Rep. Thomas H. Kean Jr.'s voting record?

Rep. Thomas H. Kean Jr. (R-NJ-7) earned a 65% Center for Healthcare Affordability score for 2025, showing moderate alignment with healthcare reform and limited-government healthcare positions. Thomas H. Kean Jr. voted on 11 of the 35 substantive bills scored by Reform Healthcare in 2025. Highest category scores: Stagnating Advancements in Healthcare (100%), Skyrocketing Insurance Premiums (100%), and Exploding Government Spending (38%). Thomas H. Kean Jr. represents New Jersey's 7th Congressional District in the U.S. House of Representatives.

How aligned is Thomas H. Kean Jr. with healthcare reform and limited-government healthcare positions?

Thomas H. Kean Jr. earned a 65% Center for Healthcare Affordability score in 2025, showing moderate alignment with healthcare reform and limited-government healthcare positions.

What is Thomas H. Kean Jr.'s Reform Healthcare score?

Thomas H. Kean Jr. has a 65% Reform Healthcare score for 2025.

Where does Thomas H. Kean Jr. serve?

Rep. Thomas H. Kean Jr. (R-NJ-7) represents New Jersey's 7th Congressional District in the U.S. House of Representatives as a Republican.

What issue categories does Thomas H. Kean Jr. score highest and lowest on?

Thomas H. Kean Jr.'s strongest categories on the Center for Healthcare Affordability scorecard are Stagnating Advancements in Healthcare (100%) and Skyrocketing Insurance Premiums (100%). The lowest-scoring categories are Exploding Government Spending (38%) and Skyrocketing Insurance Premiums (100%).

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