New Health Options Act of 2025
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Summary
The New Health Options Act of 2025 amends the Affordable Care Act to establish a reinsurance program for certain off-exchange health insurance plans, funded at $50 per member per month (capped at $6 billion annually) from 2026–2030, with an initial attachment point of $110,000 and 90 percent payment proportion. The bill allows health insurers to opt out of the ACA's single risk pool requirement for individual market plans and removes age-rating limitations (the 3-to-1 ratio) for those opt-out plans. It also requires health plans to allow out-of-network costs to count toward deductibles and out-of-pocket maximums if charges are at or below specified benchmarks, and mandates providers and facilities disclose whether patient cost-sharing would exceed uninsured prices.
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How your representatives voted
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