S. 3386: Health Care Freedom for Patients Act of 2025
Sponsor
Mike Crapo
Republican · ID
Bill Progress
Latest Action · Dec 11, 2025
Cloture on the motion to proceed to the measure not invoked in Senate by Yea-Nay Vote. 51 - 48. Record Vote Number: 643. (CR S8654)
Why it matters
If enacted, some marketplace consumers would likely see cheaper upfront premiums and new HSA deposits from HHS, especially those willing to trade richer coverage for leaner plans. Insurers and states would get more certainty from explicit funding for cost-sharing reduction payments, while certain states could receive an enhanced 80 percent expansion FMAP beginning in 2027. The losers are just as clear: people who need more comprehensive benefits could face thinner coverage options, states would face tougher federal limits on Medicaid and CHIP funding for people without verified citizenship or satisfactory immigration status, and plans sold on the exchanges could no longer count gender-transition procedures as essential health benefits.
S. 3386 Common Questions
How much would the new HHS exchange HSA deposit be per month under S3386?
Under the Health Care Freedom for Patients Act of 2025, HHS would deposit $1,000 a month for eligible enrollees ages 18–49 and $1,500 a month for ages 50–64 in 2026 and 2027 (Section 102).
Can people with income up to 700% of the poverty line get the new marketplace HSA payment?
Yes. According to S3386 Section 102, people ages 18–64 enrolled in a bronze exchange plan or catastrophic plan can qualify if household income is not more than 700% of the poverty line and other eligibility rules are met.
Can you buy a catastrophic health plan on the individual market under the Health Care Freedom for Patients Act?
Yes. Under the Health Care Freedom for Patients Act of 2025, individuals could purchase catastrophic plans in the individual market for plan years starting on or after January 1, 2027 (Section 104).
Which states would get an 80% Medicaid expansion match starting in 2027 under S3386?
According to S3386 Section 201, the 80% expansion FMAP would apply to "specified States" beginning October 1, 2027—states that provide financial aid or comprehensive health benefits to certain non-qualified aliens beyond federal requirements.
Does S3386 stop federal Medicaid and CHIP funding for people without verified immigration status?
Yes. Under the Health Care Freedom for Patients Act of 2025, federal financial participation would be barred for Medicaid and CHIP enrollees without verified citizenship, nationality, or satisfactory immigration status starting October 1, 2026 (Section 202).
Can exchange HSA money be used for abortion under the Health Care Freedom for Patients Act?
Generally no. Under the Health Care Freedom for Patients Act of 2025, exchange plan HSA funds could not be used for abortion except in cases of rape, incest, or to save the life of the mother as certified by a physician (Section 101).
Does the bill ban gender transition procedures from being treated as essential health benefits on ACA plans?
Yes. According to S3386 Section 301, essential health benefits could not include gender transition procedures for plan years beginning on or after January 1, 2027, subject to listed exceptions.
Can federal Medicaid or CHIP money pay for gender transition procedures under S3386?
Generally no. Under the Health Care Freedom for Patients Act of 2025, federal Medicaid and CHIP funds could not be used for specified gender transition procedures, with limited exceptions listed in Section 302.
Can exchange plan HSA funds be rolled over into a regular HSA under the bill?
No. According to S3386 Section 101, rollovers are not allowed except between exchange plan HSAs, so funds could not be rolled into a regular HSA.
Does the bill block cost-sharing reduction payments for exchange plans that cover abortion?
Yes. Under the Health Care Freedom for Patients Act of 2025, cost-sharing reduction funding could not be used for plans that cover abortion, except for rape, incest, or to save the life of the mother, for plan years starting in 2027 (Section 103).
Based on S. 3386 bill text
S3386 Legislative Journey
Floor Action
Dec 11, 2025
Motion to proceed to measure considered in Senate. (CR S8643)
Action Taken
Dec 9, 2025
Motion to proceed to consideration of measure withdrawn in Senate.
Introduced
Dec 8, 2025
Introduced in the Senate. Read the first time. Placed on Senate Legislative Calendar under Read the First Time. (Legislative Day December 4, 2025).
+2 more actions this day
About the Sponsor
Mike Crapo
Republican, ID · 33 years in Congress
Committees: Finance, Joint Committee on Taxation, Banking, Housing, and Urban Affairs
View full profile →
Cosponsors (1)
This bill has 1 cosponsor: 1 Republican. Cosponsors represent 1 state: Louisiana.
What laws does S. 3386 change?
5 changes
Sections Amended
Section 223 of Internal Revenue Code of 1986
adding at the end the following new subsection: ``(i) Exchange Plan HSAs
Section 223(b) of Internal Revenue Code of 1986
striking ``and'' at the end of subparagraph (B), by striking the period at the end of subparagraph (C) and inserting ``, and'', and by inserting after subparagraph (C) the following new subparagraph: ``(D) the aggregate amount contributed to an Exchange plan HSA pursuant to section 102(a) of the Health Care Freedom for Patients Act of 2025 which is excludable from the taxpayer's gross income for the taxable year under section 102(f) of such Act (and such amount shall not be allowed as a deduction under subsection (a))
Section 1402 of Patient Protection and Affordable Care Act (42 U.S.C. 18071)
adding at the end the following: ``(h) Funding
Section 1304 of Patient Protection and Affordable Care Act (42 U.S.C. 18024)
adding at the end the following new subsection: ``(f) Gender Transition Procedure
Section 1905 of Social Security Act (42 U.S.C. 1396d)
adding at the end the following new subsection: ``(ll) Specified Gender Transition Procedures
S. 3386 Quick Facts
- Chamber
- Senate
- Policy
- Health
- Introduced
- Dec 8, 2025
Cloture on the motion to proceed to the measure not invoked in Senate by Yea-Nay Vote. 51 - 48. Record Vote Number: 643. (CR S8654)
Dec 11, 2025
S. 3386 Bill Text
“To provide a health savings account contribution to certain enrollees, to reduce health care costs, and for other purposes.”
Source: U.S. Government Publishing Office
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