EXCLUSIVE – Sen. Rick Scott (R-FL) argues that his newly introduced legislation will lower the costs of health insurance for Obamacare enrollees and put money directly into patients’ pockets.
Scott’s bill, what he calls the “More Affordable Care Act,” is an attempt to mitigate the rising costs of insurance since former President Barack Obama’s healthcare law took effect in 2014, altering both the subsidy structure of the program and increasing competition by allowing insurance companies to sell plans across state lines.
“The whole goal of this is to do the opposite of what Obamacare did,” Scott told the Washington Examiner.
His legislation is a response to the debate about the year-end expiration of COVID-19-era Affordable Care Act subsidies, which were originally enacted by Democrats in 2021.
Multiple Republican senators and representatives are working on similar proposals, including Senate health committee chairman Sen. Bill Cassidy (R-LA) and Rep. Dan Crenshaw (R-TX), but Scott is the first to introduce bill text meant to articulate the GOP’s goals.
Republicans, particularly President Donald Trump, have argued in recent weeks that the temporary Obamacare enhanced premium tax credits effectively benefit the insurance companies rather than directly lowering costs for consumers.
Instead of the subsidies directed toward insurance companies, Scott’s proposal creates what he calls Trump Healthcare Freedom Accounts for patients to use subsidies directly on healthcare expenses.
The Trump Health Freedom Accounts from Scott’s bill are somewhat like health savings accounts, which Republicans have long promoted. But they would differ significantly in that they could be used to pay premium costs in addition to standard qualifying health expenses.
Scott said patients would “have the right to take whatever would have normally gone to an insurance company right into their HSA. And with that, they can buy direct healthcare.”
“You’re going to be able to decide what is important to your family and buy that insurance,” said Scott.
Scott likened an HSA-style subsidy to what is currently done with Supplemental Nutrition Assistance Program benefits, or food stamps. He said that grocery store chains are not given SNAP benefits and then told what people should eat, and that health insurance should be no different.
“I want to give the freedom back to the individual and let them start being a shopper, like we do with food stamps, a shopper of healthcare services,” Scott said.
The Health Freedom Accounts would follow the original Obamacare income-cap structure, which limits subsidies for those only making 400% of the federal poverty level, or roughly $63,000 per year for a single individual and $129,000 for a family of four.
The vast majority of Obamacare exchange enrollees are below 400% of the federal poverty level, so they will only see a modest out-of-pocket premium price increase in 2026 due to the credits expiring. But those earning more than 400% of the federal poverty level will see their health insurance prices more than double next year.
Scott said that states can choose to keep the original Obamacare subsidy structure or choose the HSA-style option.
“If you like your Obamacare, you can keep it,” he said.
Scott’s bill also would allow states to authorize insurance sales across state lines, which he argues will put downward pressure on prices across the insurance market by increasing competition.
“The state insurance commissioner will decide what plans can be sold in the state,” said Scott.
The More Affordable Care Act also would prohibit federal dollars in the Health Freedom Accounts from being spent on plans covering elective abortion services and gender transition medical procedures.
The bill text goes into significant detail about the list of procedures and treatments for gender transition that cannot be funded through Health Freedom Accounts, but clarifies that those with chromosomal abnormalities or other conditions, like early-onset puberty, can receive treatment.
Scott’s bill also clarifies that the federal dollars can be spent on abortions in cases of rape, incest, and immediate permanent injury or death to the mother, echoing the language of the Hyde Amendment for appropriations bills.
Democrats have said that including Hyde Amendment language in an Obamacare reform package is a nonstarter for negotiations.
When asked about gaining enough Democratic votes, Scott said pursuing a reconciliation bill, a Senate procedure to bypass the 60-vote majority threshold on fiscal policy matters, is in the realm of possibility. The White House earlier this week also floated the idea of pursuing a partisan reconciliation package to achieve healthcare goals early next year.
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Scott said that his Democratic colleagues “have no plan to reduce costs.”
“Obamacare caused costs to go up. Their only solution is [that] the government pay more. No, that’s wrong,” Scott said. “We have $23.2 trillion in debt. We got $2 trillion a year deficits, and we ruined the healthcare system this way.”
