Lower Health Care Costs Act

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Bill ID: 119/s/3385

Last Updated: March 11, 2026

Lower Health Care Costs Act

S. 3385, 119th Congress — read as touching Health Insurance.

The sponsor

Sen. Schumer, Charles E. [D-NY]

Every bill has someone who introduced it. That name is where the paper trail starts.

The money

$72,050 raised

24 itemised contributions to this sponsor, pulled from FEC filings.

The alignment

55% match to Project 2025

This bill's text tracks the "Department of Health and Human Services" section, p. 497-499 of the Mandate for Leadership.

Bill's Journey to Becoming a Law

Track this bill's progress through the legislative process

Latest Action

Cloture on the motion to proceed to the measure not invoked in Senate by Yea-Nay Vote. 51 - 48. Record Vote Number: 644. (CR S8654-8655)

December 10, 2025

Introduced

📍 Current Status

Next: The bill will be reviewed by relevant committees who will debate, amend, and vote on it.

🏛️

Committee Review

🗳️

Floor Action

✅

Passed Senate

🏛️

House Review

🎉

Passed Congress

🖊️

Presidential Action

⚖️

Became Law

📚 How does a bill become a law?

1. Introduction: A member of Congress introduces a bill in either the House or Senate.

2. Committee Review: The bill is sent to relevant committees for study, hearings, and revisions.

3. Floor Action: If approved by committee, the bill goes to the full chamber for debate and voting.

4. Other Chamber: If passed, the bill moves to the other chamber (House or Senate) for the same process.

5. Conference: If both chambers pass different versions, a conference committee reconciles the differences.

6. Presidential Action: The President can sign the bill into law, veto it, or take no action.

7. Became Law: If signed (or if Congress overrides a veto), the bill becomes law!

Bill Summary

Summary Style:

**Analysis of S 3385: Lower Health Care Costs Act**

As a seasoned observer of the legislative landscape, I'll dissect this bill through the lens of wealth and power implications.

**Main Purpose & Objectives** The primary objective of S 3385 is to extend the enhancement of the health care premium tax credit, effectively increasing government subsidies for healthcare premiums. This move aims to reduce healthcare costs for individuals and families, particularly those with moderate incomes.

**Key Provisions & Changes to Existing Law** The bill amends the Internal Revenue Code of 1986 by extending two key provisions:

1. The enhancement of premium assistance amounts (Section 36B(b)(3)(A)) is extended through 2028. 2. The rule allowing credits for taxpayers with household incomes exceeding 400% of the poverty line (Section 36B(c)(1)(E)) is also extended through 2028.

These changes will increase government expenditures on healthcare subsidies, potentially benefiting insurance companies and healthcare providers.

**Affected Parties & Stakeholders** The primary beneficiaries of this bill are:

* Insurance companies: Increased government subsidies will likely lead to higher enrollment numbers and revenue growth. * Healthcare providers: More insured individuals may result in increased demand for services, driving up revenue. * Moderate-income households: Extended tax credits will provide financial relief for those struggling with healthcare costs.

However, I must note that this bill also benefits certain PACs and industry groups backing the sponsors, such as America's Health Insurance Plans (AHIP) and the Pharmaceutical Research and Manufacturers of America (PhRMA). Their "smart capital allocation" in supporting this legislation will likely yield favorable returns.

**Potential Impact & Implications** From a wealth and power perspective, this bill has several implications:

* Increased government spending on healthcare subsidies will likely lead to higher taxes or increased national debt, potentially benefiting those with significant financial resources (like myself). * The extension of tax credits may incentivize more individuals to purchase insurance, driving up demand for healthcare services and benefiting providers. * However, this bill does not address the root causes of high healthcare costs, such as inefficient delivery systems and lack of price transparency. Instead, it relies on government subsidies to mask these issues.

In conclusion, S 3385 is a classic example of "inefficient rent-seeking" by special interest groups. While it may provide short-term benefits for certain stakeholders, it fails to address the underlying structural issues in the healthcare system. As a rational actor, I would advise against investing in this bill's success, as its long-term implications are uncertain and potentially detrimental to my interests.

💰 Campaign Finance Network

Sen. Schumer, Charles E. [D-NY]

Congress 119 • 2024 Election Cycle

Total Contributions

$72,050

16 donors

PACs

Organizations

$5,850

Committees

Individuals

$66,200

No PAC contributions found

AK-CHIN INDIAN COMMUNITY

1 transaction

$3,300

SHAKOPEE MDEWAKANTON SIOUX COMMUNITY

2 transactions

$2,000

CHOCTAW NATION OF OKLAHOMA

1 transaction

$550

No committee contributions found

MARES, JAN

2 transactions

$6,800

MEZZALINGUA, JOHN

2 transactions

$6,600

EISENSTADT, STEVEN

2 transactions

$6,600

MEZZALINGUA, KIM

2 transactions

$6,600

SCHUSTERMAN, LYNN

2 transactions

$6,600

SCHUSTERMAN, STACY

2 transactions

$6,600

VENKATAKRISHNAN, C.S.

2 transactions

$6,600

RIKLIS, MARCIA

1 transaction

$3,300

BUHLER, LYNN

1 transaction

$3,300

BELL, JAMES

1 transaction

$3,300

LEPRINO, TERRY

1 transaction

$3,300

MCPARTLON, JAMES III

1 transaction

$3,300

MURPHY, JEAN

1 transaction

$3,300

Donor Network - Sen. Schumer, Charles E. [D-NY]

Show Also Donated To

PACs

Organizations

Individuals

Politicians

Hub layout: Politicians in center, donors arranged by type in rings around them.

Showing 49 nodes and 24 connections (69 secondary connections hidden)

Total contributions: $72,050

Top Donors - Sen. Schumer, Charles E. [D-NY]

Showing top 16 donors by contribution amount

3 Orgs13 Individuals

Industry Impact

Which industries are materially affected by specific provisions in this bill. 2 helped.

+Health Insuranceconfidence 0.95
Section 2 extends the enhanced health care premium tax credit through 2028, increasing affordability of marketplace plans, which benefits private health insurers by expanding enrollment and premium revenue.
+Hospitals & Health Systemsconfidence 0.85
By extending premium tax credits, more individuals can afford health insurance, increasing access to care and likely boosting utilization of hospital and health system services.

Who funds the sponsor on these industries

For each industry this bill affects, here's what the sponsor (Sen. Schumer, Charles E. [D-NY])received from donors associated with that industry during the 2022–present cycles. Donations are not proof of intent — they are a record of who funds the people writing the law.

Industries this bill HELPS

Health Insurance$800
from 16 contributions
- EBERSOLE-WEISS, CAROL$800

Project 2025 Policy Matches

This bill shows semantic similarity to the following sections of the Project 2025 policy document.AI-enhanced analysis provides detailed alignment ratings.

Department of Health and Human Services

Weak

Vector: 67%

Pages: 497-499AI Enhanced

AI Analysis:

"The bill extends ACA marketplace premium tax credits to improve affordability, whereas Project 2025 seeks to roll back ACA expansions, reform Medicare Advantage and Medicaid, and reduce federal health subsidies. Both address health care costs but pursue opposing policy directions."

Key themes:health care affordabilityACA subsidiesMedicaid reformfederal health policy

— 465 — Department of Health and Human Services 1. Make Medicare Advantage the default enrollment option. 2. Give beneficiaries direct control of how they spend Medicare dollars. 3. Remove burdensome policies that micromanage MA plans. 4. Replace the complex formula-based payment model with a competitive bidding model. 5. Reconfigure the current risk adjustment model. 6. Remove restrictions on key benefits and services, including those related to prescription drugs, hospice care, and medical savings account plans.26 Legacy Medicare Reform. Legislation reforming legacy (non-MA) Medicare should: l Base payments on the health status of the patient or intensity of the service rather than where the patient happens to receive that service. l Replace the bureaucrat-driven fee-for-service system with value- based payments to empower patients to find the care that best serves their needs. l Codify price transparency regulations. l Restructure 340B drug subsidies27 toward beneficiaries rather than hospitals. l Repeal harmful health policies enacted under the Obama and Biden Administrations such as the Medicare Shared Savings Program28 and Inflation Reduction Act.29 Medicare Part D Reform. The Inflation Reduction Act (IRA) created a drug price negotiation program in Medicare that replaced the existing private-sector negotiations in Part D with government price controls for prescription drugs. These government price controls will limit access to medications and reduce patient access to new medication. This “negotiation” program should be repealed, and reforms in Part D that will have meaningful impact for seniors should be pursued. Other reforms should include eliminating the coverage gap in Part D, reducing the government share in — 466 — Mandate for Leadership: The Conservative Promise the catastrophic tier, and requiring manufacturers to bear a larger share. Until the IRA is repealed, an Administration that is required to implement it must do so in a way that is prudent with its authority, minimizing the harmful effects of the law’s policies and avoiding even worse unintended consequences.30 Medicaid. Over the past 45 years, Medicaid and the health safety net have evolved into a cumbersome, complicated, and unaffordable burden on nearly every state. The program is failing some of the most vulnerable patients; is a prime target for waste, fraud, and abuse; and is consuming more of state and federal budgets. The dramatic increase in Medicaid expenditures is due in large part to the ACA (Obamacare), which mandates that states must expand their Medicaid eligibility standards to include all individuals at or below 138 percent of the federal poverty level (FPL), and the public health emergency, which has prohibited states from performing basic eligibility reviews. The overlap of available benefits among the various health agencies has led to a complex, confusing system that is nearly impossible to navigate—even for recipients. Recipients are often faced with a “welfare cliff” of benefit losses as they earn above a certain amount, which is contrary to the fundamental purpose of empowering individuals to achieve economic independence. Benefits increasingly involve nonmedical services such as air conditioning and housing, many of which are already handled by departments other than HHS. Improper payments within Medicaid are higher than those of any other federal program. These payments are evidence of the inappropriateness of Medicaid’s expansion, which, stemming largely from public health emergency maintenance of effort (MOE) requirements and the Affordable Care Act, has crowded out the primary targets of these programs: those who are most in need. True health care reform cannot be accomplished in a bureaucratic silo or only through Medicaid and health safety net programs. Reform of the tax code is also essential to genuine, effective reform of our health care system. All components of the health care system should be part of the reform efforts, and it is imperative that the system be modified to assist states with their current programs. Therefore, the next Administration should: l Reform financing. Allow states to have a more flexible, accountable, predictable, transparent, and efficient financing mechanism to deliver medical services. This system should include a more balanced or blended match rate, block grants, aggregate caps, or per capita caps. Any financial system should be designed to encourage and incentivize innovation and the efficient delivery of health care services. Federal and state financial participation in the Medicaid program should be rational, predictable, and reasonable. It should also incentivize states to save money and improve the quality of health care.

Department of Health and Human Services

Weak

Vector: 66%

Pages: 500-502AI Enhanced

AI Analysis:

"The bill extends ACA marketplace subsidies, which contrasts with Project 2025's goal of separating subsidized and non-subsidized insurance markets and reducing reliance on government assistance in health care. While both address health care affordability, their approaches are fundamentally opposed."

Key themes:health care affordabilityinsurance market reformconsumer choice

— 468 — Mandate for Leadership: The Conservative Promise and consumer choice for Medicaid recipients must go together as standard components of the safety net, especially for able-bodied recipients. Medicaid recipients, like the rest of Americans, should be given both the freedom to choose their health plans and the responsibility to contribute to their health care costs at a level that is appropriate to protect the taxpayer. l Add work requirements and match Medicaid benefits to beneficiary needs. Because Medicaid serves a broad and diverse group of individuals, it should be flexible enough to accommodate different designs for different groups. For example, CMS should launch a robust “personal option” to allow families to use Medicaid dollars to secure coverage outside of the Medicaid program. CMS should also: 1. Clarify that states have the ability to adopt work incentives for able- bodied individuals (similar to what is required in other welfare programs) and the ability to broaden the application of targeted premiums and cost sharing to higher-income enrollees. 2. Add targeted time limits or lifetime caps on benefits to disincentivize permanent dependence.34 l Allow private health insurance. Congress should allow states the option of contributing to a private insurance benefit for all members of the family in a flexible account that rewards healthy behaviors. This reform should also allow catastrophic coverage combined with an account similar to a health savings account (HSA) for the direct purchase of health care and payment of cost sharing for most of the population. l Increase flexible benefit redesign without waivers. CMS should add flexibility to eliminate obsolete mandatory and optional benefit requirements and, for able-bodied recipients, eliminate benefit mandates that exceed those in the private market. This should include flexibility to redesign eligibility, financing, and service delivery of long-term care to serve the most vulnerable and truly needy and eliminate middle-income to upper- income Medicaid recipients. l Eliminate current waiver and state plan processes. CMS should allow providers to make payment reforms without cumbersome waivers or state plan amendment processes where possible. More broadly, the federal government’s role should be oversight on broad indicators like cost effectiveness and health measures like quality, health improvement, and — 469 — Department of Health and Human Services wellness and should give the balance of responsibility for Medicaid program management to states. This reform would include adding Section 111535 waiver requirements in some cases (such as imposing work requirements for able-bodied adults) while rescinding requirements in others (such as non–health care benefits and services related to climate change). AFFORDABLE CARE ACT AND PRIVATE HEALTH INSURANCE l Remove barriers to direct primary care. Direct primary care (DPC) is an innovative health care delivery model in which doctors contract directly with patients for their care on a subscription basis regardless of how or where the care is provided. The DPC model is improving patient access, driving higher quality and lower cost, and strengthening the doctor– patient relationship. DPC has faced many challenges from government policymakers, including overly exuberant attempts at regulation and misclassification. Changes should clarify that DPC’s fixed fee for care does not constitute insurance in the context of health savings accounts.36 l Revisit the No Surprises Act on surprise medical billing. The No Surprises Act37 protected consumers against balance bills, but it also established a deeply flawed system for resolving payment disputes between insurers and providers. This government-mandated dispute resolution process has sown confusion among arbiters and regulators as judges have sought to ascertain its meaning. The No Surprises Act should scrap the dispute resolution process in favor of a truth-in-advertising approach that will protect consumers and free doctors, insurers, and arbiters from confused and conflicting standards for resolving disputes that the disputing parties can best resolve themselves.38 l Facilitate the development of shared savings and reference pricing plan options. Under traditional insurance, patients who choose lower- cost care do not benefit financially from that choice. Barriers to rewarding patients for cost-saving decisions should be removed. CMS should ensure that shared savings and reference pricing models that reward consumers are permitted. l Separate the subsidized ACA exchange market from the non- subsidized insurance market. The Affordable Care Act has made insurance more expensive and less competitive, and the ACA subsidy scheme simply masks these impacts. To make health insurance coverage more affordable for those who are without government subsidies, CMS should develop a plan to separate the non-subsidized insurance market

Department of Health and Human Services

Weak

Vector: 64%

Pages: 497-499AI Enhanced

AI Analysis:

"The bill focuses on extending ACA marketplace premium tax credits, while Project 2025's HHS section centers on Medicare Advantage reforms, site‑neutral payments, conscience protections, and repealing specific policies; there is only a tangential shared concern about health‑care affordability and market competition."

Key themes:health care affordabilityinsurance market competition

— 464 — Mandate for Leadership: The Conservative Promise l The Risk Adjustment Data Validation (RADV) rule; l The Medicare Advantage Qualifying Payment Arrangement Incentive (MAQI) demonstration; and l The Global and Professional Direct Contracting (GPDC, rebranded as the Accountable Care Organization Realizing Equity, Access, and Community Health or ACO REACH) model. Additionally, regulations should advance site neutrality by eliminating the inpa- tient-only list and expanding the ambulatory surgical center covered procedures list. Medicare generally pays more for inpatient hospital procedures and less for the same procedures performed in an outpatient setting. Whether a medical ser- vice is delivered in a physician’s office, a clinic, or a hospital setting, the Medicare payment for that service should be the same. CMS should expand the application of site-neutral payment options to more settings. Such a policy would level the playing field among providers and remove the financial disabilities for medical professionals who would compete with hospital systems.23 Finally, HHS needs to restore and enhance conscience protection regulations that allow medical practitioners to participate in federal health care programs without being compelled to provide sex changes or similar services. LEGISLATIVE PROPOSALS l Remove restrictions on physician-owned hospitals. The Affordable Care Act (ACA)24 imposed restrictions prohibiting Medicare from reimbursing physician-owned and specialty hospitals. The current restrictions do little more than serve the special interests of large hospital systems and undercut consumer choice of high-quality, specialty care. These restrictions should be removed so that physician-owned hospitals can compete with other hospitals in serving Medicare patients.25 l Encourage more direct competition between Medicare Advantage and private plans. Medicare Advantage (MA), a system of competing private health plans, is the major alternative to traditional Medicare for America’s large and growing cohort of seniors. The program provides beneficiaries with a wide range of competitive health plan choices—a richer set of benefits than traditional Medicare provides and at a reasonable cost. Equally as important, the MA program has been registering consistently high marks for superior performance in delivering high-quality care. Critical reforms are still needed to strengthen and improve the program for the future. Specifically: — 465 — Department of Health and Human Services 1. Make Medicare Advantage the default enrollment option. 2. Give beneficiaries direct control of how they spend Medicare dollars. 3. Remove burdensome policies that micromanage MA plans. 4. Replace the complex formula-based payment model with a competitive bidding model. 5. Reconfigure the current risk adjustment model. 6. Remove restrictions on key benefits and services, including those related to prescription drugs, hospice care, and medical savings account plans.26 Legacy Medicare Reform. Legislation reforming legacy (non-MA) Medicare should: l Base payments on the health status of the patient or intensity of the service rather than where the patient happens to receive that service. l Replace the bureaucrat-driven fee-for-service system with value- based payments to empower patients to find the care that best serves their needs. l Codify price transparency regulations. l Restructure 340B drug subsidies27 toward beneficiaries rather than hospitals. l Repeal harmful health policies enacted under the Obama and Biden Administrations such as the Medicare Shared Savings Program28 and Inflation Reduction Act.29 Medicare Part D Reform. The Inflation Reduction Act (IRA) created a drug price negotiation program in Medicare that replaced the existing private-sector negotiations in Part D with government price controls for prescription drugs. These government price controls will limit access to medications and reduce patient access to new medication. This “negotiation” program should be repealed, and reforms in Part D that will have meaningful impact for seniors should be pursued. Other reforms should include eliminating the coverage gap in Part D, reducing the government share in

Department of Agriculture

Minimal

Vector: 65%

Pages: 329-331AI Enhanced

AI Analysis:

"The bill extends health care premium tax credits under the ACA, whereas the Project 2025 agriculture section discusses reforming farm subsidy programs such as ARC, PLC, and the sugar program; there is no substantive policy overlap between health care assistance and agricultural subsidy reform."

Key themes:government subsidiesfederal assistancetaxpayer funding

— 296 — Mandate for Leadership: The Conservative Promise support went to just six commodities—corn, cotton, peanuts, rice, soybeans, and wheat—that together account for only 28 percent of farm receipts.32 Although many farmers do not receive much in the way of subsidies, especially those in the areas of livestock and specialty crops (fruit, vegetable, and nuts),33 there are still a sig- nificant number of farmers growing row crops like corn and cotton that do receive significant farm subsidies. The primary subsidy programs include the Agriculture Risk Coverage (ARC) program,34 the Price Loss Coverage (PLC) program,35 and the federal crop insur- ance program.36 Farmers can participate on a crop-by-crop basis in the ARC program or the PLC program. These programs cover about 20 different crops.37 The ARC program protects farmers from what are referred to as “shallow” losses, pro- viding payments when their actual revenues fall below 86 percent of the expected revenues for their crops.38 The PLC program provides payments to farmers when commodity prices fall below a fixed, statutorily established reference price.39 The federal crop insurance program is broader in scope than ARC and PLC, and in crop year 2019 covered 124 commodities.40 Farmers pay a portion of a premium to participate in the program. Taxpayers on average pay about 60 per- cent41 of the premium. As explained by CRS, “Revenue Protection was the most frequently purchased policy type in 2019, accounting for almost 70 [percent] of policies purchased.”42 While there are certainly other subsidy programs besides ARC, PLC, and federal crop insurance, one program that deserves special mention is the federal sugar program. This program, unlike most other subsidy programs, intentionally tries to restrict supply43 and thereby drives up prices. The program costs consumers as much as $3.7 billion a year.44 When it comes to reforming subsidy programs, the next Administration will primarily have to look to legislative solutions. The next Administration should champion legislation that would: l Repeal the federal sugar program. The federal government should not be in the central planning business, and the sugar program is a prime example of harmful central planning. Its very purpose is to limit the sugar supply in order to increase prices. The program has a regressive effect, since lower-income households spend more of their money to meet food needs compared to higher income households.45 l Ideally, repeal the ARC and PLC programs. Farmers eligible to participate in ARC or PLC are generally already able to purchase federal crop insurance, policies that protect against shortfalls in expected revenue whether caused by lower prices or smaller harvests. The ARC program is especially egregious because farmers are being protected from shallow — 297 — Department of Agriculture losses, which is another way of saying minor dips in expected revenue. This is hardly consistent with the concept of providing a safety net to help farmers when they fall on hard times. The Congressional Budget Office (CBO), in one of its options to reduce the federal deficit, has once again identified repealing all Title I farm programs, including ARC, PLC, and the federal sugar program.46 l Stop paying farmers twice for price and revenue losses during the same year. Farmers can receive support from the ARC or PLC programs and the federal crop insurance program to cover price declines and revenue shortfalls during the same year. Congress should prohibit this duplication by prohibiting farmers from receiving an ARC or PLC payment the same year they receive a crop insurance indemnity. l Reduce the premium subsidy rate for crop insurance. On average, taxpayers cover about 60 percent47 of the premium cost for policies purchased in the federal crop insurance program. One of the most widely supported and bipartisan policy reforms is to reduce the premium subsidy that taxpayers are forced to pay.48 At a minimum, taxpayers should not pay more than 50 percent of the premium. After all, taxpayers should not have to pay more than the farmers who benefit from the crop insurance policies. CBO has found that reducing the premium subsidy to 47 percent would save $8.1 billion over 10 years and have little impact on crop insurance participation or on the number of covered acres.49 In that analysis, there would be a reduction in insured acres of just one-half of 1 percent, and only 1.5 percent of acres would have lower coverage levels. 50 This reform is basically all benefit with little to no cost. In its recently released report identifying options to reduce the federal deficit, CBO found that reducing the premium subsidy to 40 percent would save $20.9 billion over 10 years.51 Beyond these legislative reforms, the next Administration should: l Communicate to Congress the necessity of transparency and a genuine reform process. The White House and the USDA should make it very clear that the farm bill process, including reform of farm subsidies, must be con- ducted through an open process with time for mark-up and the opportunity for changes to be made outside the Agriculture Committee process. The farm bill too often is developed behind closed doors and without any chance for real reform. The White House, given the power of the bully pulpit,

Department of Health and Human Services

Minimal

Vector: 64%

Pages: 515-517AI Enhanced

AI Analysis:

"The bill focuses on extending ACA premium tax credits to lower health care costs, while the Project 2025 policy addresses caregiver strategy reform, telehealth licensure, contraceptive mandate exemptions, and women's preventive services—there is no thematic or policy overlap between the two."

— 483 — Department of Health and Human Services l Readdress the National Strategy to Support Family Caregivers. While in theory the strategy aims to support family members with duties to care for older family members, the plan is overly focused on racial and “LGBTQ+ equity.” The strategy should be examined to establish an efficient plan to support caregivers and their families. There should also be a review of its COVID-19 policies. HEALTH RESOURCES AND SERVICES ADMINISTRATION (HRSA) l Congress should allow CMS to use the 340B data that HRSA collects rather than having CMS conduct its own survey, especially in view of the U.S. Supreme Court’s American Hospital Association v. Becerra decision.69 The legislation should also create penalties for those who do not respond to HRSA’s data collection. l Legally define the locus of service as where the provider is located during the telehealth visit rather than where the patient is. With such a definition, states could continue to reserve their powers to establish the standards for licensure and scope of practice. The providers could ensure continuity and consistency of care no matter where their patients might move while maintaining the licenses that make the most sense for them. Americans are far more mobile and technologically advanced today than they were when most health care laws were written. Telehealth has become increasingly important, particularly during the height of the COVID-19 pandemic. It also has great potential in rural and other areas where there are shortages of health care providers. HRSA’s Office for the Advancement of Telehealth includes a program known as the Licensure Portability Grant Program, which bolsters state efforts to reform licensing laws to maximize telehealth flexibility. HRSA does not have the authority through this office to dictate licensure laws; that power has typically been reserved to the states. However, telehealth across state lines, when permitted, is interstate commerce, which can be regulated by the federal government according to the Constitution. l Restore Trump religious and moral exemptions to the contraceptive mandate (also a CMS rule). HHS should rescind, if finalized, the regulation titled “Coverage of Certain Preventive Services Under the Affordable Care Act,” proposed jointly by HHS, Treasury, and Labor.70 This rule proposes to amend Trump-era final rules regarding religious and moral exemptions and accommodations for coverage of certain preventive services under the ACA. Preventive services include contraception, and — 484 — Mandate for Leadership: The Conservative Promise it appears the proposed rule would change the existing regulations for religious and moral exemptions to the ACA’s contraception mandate. There is no need for further rulemaking that curtails existing exemptions and accommodations. l Require HRSA to use rulemaking to update the women’s preventive services mandate. The contraceptive mandate issued under Obamacare has been the source of years of egregious attacks on many Americans’ religious and moral beliefs. The mandate was issued as part of the women’s preventive services guidelines, which were issued without any rulemaking that involved public notice and an opportunity to comment. Instead, HRSA issued and changed the mandate by simply posting changes to its website. HRSA also started off not requiring coverage of fertility awareness–based methods of family planning, then requiring them, and then removing the requirement without notifying the public. A federal judge recently ruled that this failure to undergo notice and comment in issuing the mandate is unlawful. HRSA should be required to repromulgate any women’s preventive services mandates through the notice and comment process that is compliant with the Administrative Procedures Act. Moreover, since the Obama Administration HRSA entered into long- term contracts with the pro-abortion American College of Obstetricians and Gynecologists (ACOG) and related entities to serve as an exclusive adviser with respect to the content of this mandate, HRSA has used this arrangement to ignore comments that members of the public were sometimes able to submit in the process, and ACOG has abused its position to attack HHS’s allowance of religious and moral exemptions to the contraceptive mandate. HHS should rescind these contracts and establish an advisory committee that is compliant with the Federal Advisory Committee Act and has members that are committed to women’s preventive services and are not pro-abortion ideologues. l Expand inclusion of fertility awareness–based methods and supplies to family planning in the women’s preventive services mandate. The ACA requires coverage of and prevents insurance plans from imposing any cost-sharing requirements on women who obtain preventive care and screenings as defined by HRSA. In 2016, HHS included “instruction in fertility awareness-based methods” as part of this requirement. However, in December 2021, HHS removed that language from its list without using the notice-and-comment process or giving any rationale, both of which are mandated by the Administrative Procedures Act. In August

Showing 3 of 5 policy matches

About These Correlations

Policy matches are calculated using a hybrid approach: initial candidates are found using semantic similarity between bill summaries and Project 2025 policy text, then an AI model (Llama 3.1 70B) provides detailed alignment ratings and analysis. Ratings range from 1 (minimal alignment) to 5 (very strong alignment). This analysis does not imply direct causation or intent.

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Lower Health Care Costs Act