This bill provides states with three options regarding title I (provisions on health insurance reform, exchanges, and subsidies) of the Patient Protection and Affordable Care Act (PPACA): (1) continue implementing PPACA, (2) do not apply title I of PPACA except to prohibit lifetime or annual limits on health insurance benefits and require coverage of dependents up to 26 years old, or (3) the second option plus implementation of a health savings account (HSA) deposit system.

In states implementing an HSA deposit system, residents who are enrolled in health insurance coverage that meets state standards receive monthly deposits in their HSAs either from states administering federal funds or as a tax credit paid in advance. States that administer deposits are entitled to payments from the Department of Health and Human Services for population health initiatives.

States with an HSA deposit system must offer a health insurance plan that is continually available for enrollment and penalize residents who have a break in coverage.

This bill amends title XIX (Medicaid) of the Social Security Act (SSAct) to disregard assets in an HSA for purposes of determining Medicaid eligibility and benefits except for long-term care services.

This bill amends SSAct title XVIII (Medicare) to require participating hospitals to limit costs to individuals for uncovered emergency medical care.

This bill amends the Internal Revenue Code to eliminate the requirement that an individual have a high deductible health plan to be eligible for the tax benefits of an HSA.

HSAs can be used to pay premiums for health insurance that meets specified requirements.