A Republican bill with 4 Republican cosponsors · See all 4 cosponsors
Last activity — Read twice and referred to the Committee on Finance.
In committee
Introduced and handed to a committee in the chamber it started in.
The committee holds it, and most bills are never heard from again. A hearing or a committee vote would be news; silence is the usual outcome, and it kills the bill without anyone voting against it.
Its path through Congress
- Introduced
- In Committee
What this bill would do
The "Custom Health Option and Individual Care Expense Act," or "CHOICE Act," updates the Internal Revenue Code to allow for a specific type of health reimbursement arrangement. These arrangements are employer-funded and provide payments for medical care to employees who have individual health insurance or Medicare. The bill establishes rules for nondiscrimination, substantiation, and notice for these plans. It also creates a tax credit for eligible employers who provide these arrangements. Additionally, it allows participants in these arrangements to purchase exchange insurance under a cafeteria plan.
Yes· 3 of 15
- Scored +7
Would business owners be better off under this?
Offers a significant tax credit to small business owners for providing these benefits.
- Scored +6
Does this make it easier to run a small business?
Gives small businesses a direct financial incentive via tax credits to provide flexible health benefits.
- Scored +5
Would people over 65 be better off under this?
Specifically allows Medicare recipients to participate in these reimbursement arrangements.
The opposite
- Scored -1
Does this reduce what the federal government owes?
Creates a new tax credit for employers, which slightly reduces federal tax revenue.
Who it would affect, and how
Potential Positive Impacts for People
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Increased Flexibility in Health Coverage: Employees can receive employer-funded reimbursements for medical care while maintaining individual health insurance or Medicare coverage, as described in Section 2(a)(2)(B)(ii).
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Employer Incentives to Provide Benefits: Small employers (those who are not applicable large employers) may receive a tax credit of $100 per month for the first year and half that amount for the second year for each enrolled employee, which may encourage them to offer these benefits under Section 4(a).
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Access to Exchange Insurance: Employees in a CHOICE arrangement are granted an exception that allows them to purchase exchange insurance under a cafeteria plan, according to Section 3(a).
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Protections Against Discrimination: The bill requires that these arrangements be offered to all employees within a specified class on the same terms, as detailed in Section 2(a)(2)(C)(i).
Potential Negative Impacts for People
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Limited Availability Based on Employee Class: Employers can restrict these arrangements to specific "specified classes" of employees, such as full-time, part-time, or salaried employees, which means not all employees at a company may be eligible under Section 2(a)(2)(C)(ii).
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Coverage Requirements: To receive reimbursements, individuals must maintain specific types of coverage, such as individual health insurance (excluding excepted benefits) or Medicare, as stated in Section 2(a)(2)(B)(ii).
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Reporting Requirements: The total amount of permitted benefits received under a CHOICE arrangement will be included on the employee's W-2, as required by Section 2(b)(1).
Groups and Interests Ranking
Every group the model scored this bill for, from -10 to +10. Tap or hover a score for the reason it gave.
- Demographic And Interest Groups
- Would business owners be better off under this? — Offers a significant tax credit to small business owners for providing these benefits. Would retired people be better off under this? — Seniors on Medicare are explicitly eligible for these employer-funded reimbursements. Would people over 65 be better off under this? — Specifically allows Medicare recipients to participate in these reimbursement arrangements. Would households on low incomes be better off under this? — Lowers the net cost of health insurance through employer-funded reimbursements. Would middle-income households be better off under this? — Increases flexibility and financial support for maintaining health coverage. Would people in middle age be better off under this? — Offers flexibility in health coverage and employer-funded reimbursements. Would people in their twenties and thirties be better off under this? — Provides an option for those in the individual market to receive employer support. Would high-income households be better off under this? — Provides additional tax-advantaged ways to handle medical expenses.
- Economy And Finance
- Does this make it easier to run a small business? — Gives small businesses a direct financial incentive via tax credits to provide flexible health benefits. Does this cut taxes for small businesses? — Provides a tax credit of up to $100 per month per employee for small employers establishing CHOICE arrangements. Does this cut taxes for middle-income families? — Provides tax-free employer reimbursements for medical care for employees with individual insurance. Is this likely to grow the economy? — Encourages small business benefit offerings and individual market insurance utilization. Does this reduce what the federal government owes? — Creates a new tax credit for employers, which slightly reduces federal tax revenue.
- Healthcare
- Does this make health care easier to get in general? — Increases financial support for employees to maintain individual or Medicare health insurance. Does this strengthen the Affordable Care Act? — Facilitates the purchase of exchange insurance and integration with individual market coverage.
- Social Issues And Justice
- Is this likely to lift people out of poverty? — Helps lower-income employees afford health insurance through employer reimbursements.
- 6/9/2026
- 1 Cosponsor added.
- 11/20/2025
- 1 Cosponsor added.
- 11/19/2025
- 1 Cosponsor added.
- 11/18/2025
- 1 Cosponsor added.
- 9/18/2025
- Read twice and referred to the Committee on Finance.
- Introduced in Senate
2 bills Congress.gov lists as related to this one — companions in the other chamber, earlier versions, and bills this one absorbed or was folded into.
Marsha BlackburnRepublican · Tennessee
Jim BanksRepublican · Indiana
Kevin CramerRepublican · North Dakota
Roger MarshallRepublican · Kansas