Q&A of the Day – What’s in Senator Rick Scott’s More Affordable Care Act?
Each day I feature a listener question sent by one of these methods.
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Today’s entry: I heard you talking with Senator Scott about healthcare. The health savings accounts sounded promising. Can you break down the changes with his healthcare plan? Thank you!
Bottom Line: Healthcare affordability challenges are nothing new, however Senator Rick Scott has picked up on ideas aimed at improving affordability floated by President Trump, aka Trumpcare, along with his own ideas as a former healthcare CEO into a bill known as the More Affordable Care Act. Of course, the irony of President Obama’s “Affordable Care Act” is that healthcare has only become less affordable over time with its passage. This is largely due to the biggest obstacle to more affordable healthcare, health insurance, having been expanded under “Obamacare” preventing almost all Americans from actually knowing what the cost of healthcare will be until after they’ve already obtained it.
While healthcare affordability remains a significant challenge for many families, the current inflection point involves the end of the COVID-era subsidies for exchange-based ACA plans which expired at the end of 2025. As my prior analysis has revealed, The average federal taxpayer is paying $780 annually for the Obamacare subsidies. The net income tax burden – meaning for those who are net federal income taxpayers – is $1,560 per year. Most recently, 92% of the 21 million Americans using Obamacare exchange-based policies were receiving taxpayer subsidies covering 80%+ of the total cost of those health insurance plans.
In other words, for the average American, in addition to what you’ve paid for your health insurance and net health insurance costs, you've also been compelled by a law (passed by congressional Democrats and signed by President Biden) to pay an additional $780 to $1,560 for healthcare to subsidize the ACA policies annually. Democrats would like to extend the policy for years to come. President Trump and most congressional Republicans would like to overhaul the current healthcare law. So, about what’s in the current version of the proposed “More Affordable Care Act”?
- Establishes a Health Freedom Waiver Program: Allows states to apply for waivers from federal health care regulations including the Affordable Care Act and Medicaid rules, aimed at promoting innovation, reducing costs, increasing flexibility in health coverage options.
- Establishes Health Freedom Accounts: Referred to as “Trump Health Freedom Accounts”, any subsidies currently paid directly to health insurance companies would instead be paid directly into a Health Savings Account for individuals so they could use the money for their healthcare needs as they see fit.
- Promotes Better Price Reporting: Introduces requirements or incentives for greater transparency in health care pricing, such as mandating hospitals, insurers, and providers to report prices more accurately allowing for increased consumer price transparency.
- Focus on Improved Outcomes: Reforms payments to states that are based on measurable health outcomes through mandatory data reporting.
- Deregulation: Reduces regulatory burdens, encouraging market-based approaches, addresses surprise billing, drug pricing, or interstate insurance sales
So, to summarize how would the legislation impact you?
- Give states increased flexibility from ACA requirements through a new waiver program.
- Redirects federal healthcare subsidies from insurance companies to individuals in personalized health savings accounts.
- Expands state-level choice and competition in insurance coverage of health coverage.
- Increases pricing transparency and consumer access to cost/outcome data.
As currently written the legislation addresses all aspects of health care affordability concerns, I’ve long voiced. This would result in consumer choice in healthcare, significantly improved price transparency, and also likely lead to a change in philosophy generally. Senator Scott indicated that he believed that the healthcare first model, as opposed to the health insurance first model, used to replace the failures of the ACA – would likely result in the rest of society following that lead. So, what does that mean?
In 2025, the average employer paid $7,798 towards an employee’s health insurance plan (a total that jumps to $20,143 for the average family plan). Imagine if rather than $7,800 to $20,100 being paid directly to insurance companies, that money were to flow to your health savings account instead? And btw, that’s in addition to the $1,527 that the average employee pays toward their employer sponsored plan or the average $6,850 that’s paid by employees for their family plan. Would you rather choose how to use all that money for your family’s healthcare needs? How much savings do you think there would likely be? What we’re talking about would be truly transformational in solving the actual healthcare affordability crisis in this country. Now the legislation is still being written, and it’s important that the final product equals the explanation, but if it does – this needs to get done. Obamacare was an abomination. The More Affordable Care Act, aka, Trumpcare has the potential to change everything for the better.