$1 Trillion Pay-For Provision Unveiled in Great American Healthcare Act

Congressman Eric Burlison (MO-07) has unveiled the pay-for provision in his Great American Healthcare Act, which targets a Federal Reserve payment stream projected to exceed $1 trillion over the next decade. This projection was made by the Foundation for Government Accountability and subsequently incorporated into the Heritage Foundation's 2026 American Opportunity Agenda.

The legislation would repeal the Federal Reserve's broad authority to pay interest on reserve balances while preserving a narrower earnings mechanism for supplemental reserves. The projected savings would offset reforms designed to put patients back in control of their healthcare dollars.

Burlison stated, 'Every healthcare proposal eventually runs into the same question: How do you pay for it?' He added that his bill answers this question by reforming the Federal Reserve's authority to pay interest on reserve balances and using the savings to help offset the cost of putting patients back in charge of their health care.

The Great American Healthcare Act would allow every American to have a health savings account (HSA), raise the annual contribution limit to the same level as a 401(k), expand qualified HSA expenses, create new healthcare options, strengthen price transparency and improve access to prescription drugs. Additionally, families could transfer up to $5,000 tax-free from an HSA into a Trump Account, helping the next generation begin building long-term savings.