Bill > HR1776

This bill establishes a new Reinsurance Program under the Affordable Care Act to help lower health insurance premiums for certain individual health insurance plans from 2026 to 2030. The program will provide financial support to health insurance issuers for high-cost claims, with an annual funding cap of $6 billion, calculated at $50 per member month. For the initial year (2026), the program sets a specific attachment point of $110,000, with the government covering 90% of claims up to a cap of $300,000 per individual. The bill also allows health insurance issuers to opt out of the traditional single risk pool for certain plans, which could impact how premiums are calculated. Additionally, the legislation includes two other key provisions: first, a requirement that out-of-network healthcare costs can be applied to a patient's in-network deductible under certain conditions, and second, a mandate that healthcare providers disclose to patients whether they would be charged more with insurance than without. These changes aim to increase transparency in healthcare pricing and provide financial relief to individual health insurance markets. The bill is set to take effect for plan years beginning on or after January 1, 2026.