U.S. Senator Rand Paul (R-Ky.) has introduced the Health Marketplace and Savings Accounts for All Act, a bill aimed at making Health Savings Accounts (HSAs) available to all Americans and expanding Association Health Plans to help reduce health insurance premiums.
According to Senator Paul, “Two of the most daunting problems facing Americans are the lack of affordable healthcare options and the fear of exorbitant medical bills. With my plan, to provide the leverage needed to reduce the cost of premiums, nearly any conceivable membership entity, such as Costco or Amazon, would be empowered to collectively bargain on behalf of their members with health insurers to lower rates. Additionally, this legislation improves the treatment of health savings accounts so all Americans can obtain them, increases the tax-free maximum contribution by thousands of dollars, and expands what HSAs can be used to pay for, such as health insurance premiums and gym memberships. If we want lower premiums and better care, we need more choice and competition.”
The proposed legislation addresses concerns that many people who do not work for large employers have limited access to favorable insurance rates due to lack of bargaining power. It also seeks solutions for those burdened by medical debt in the United States.
Currently, HSAs allow millions of people to save pre-tax money for medical expenses not covered by insurance. These accounts remain with individuals even if they change jobs or become unemployed.
If enacted, Senator Paul’s bill would make several changes:
– All Americans could open an HSA regardless of income or current coverage.
– The annual HSA contribution limit would increase significantly from $4,400 per individual ($8,750 per family) in 2026 to $24,500.
– The range of expenses eligible under HSAs would broaden to include items like insurance premiums, vitamins and supplements, gym memberships, and wearable fitness trackers.
The act also aims to reform Association Health Plans by allowing any membership-based organization—not just employers—to sponsor a group health plan across state lines. This would enable organizations such as rideshare companies or wholesale clubs to negotiate collectively with insurers on behalf of their members. The proposal includes provisions intended to protect coverage during periods when individuals lose or change jobs.
