With Affordable Care Act subsidies set to expire this month and the Senate failing to invoke cloture on a new GOP healthcare bill, Washington has once again shown it has no plan to rein in soaring premiums. As coverage options shrink and costs climb, Obama- and Biden-era regulations continue to squeeze consumers.

Americans are facing a healthcare crisis of dwindling insurance options and rising costs.

Healthcare costs are outpacing inflation. Fortunately, a proposal by Sen. Rand Paul, R-Ky., would turbocharge choice and competition in healthcare while scaling back the government’s role. Americans deserve fiscally responsible and commonsense reforms that don’t break the bank.

A Kaiser Family Foundation report in October highlights that healthcare costs remain a significant challenge for many, with 50% of U.S. adults finding it difficult to afford healthcare. A quarter of Americans have had difficulty paying for healthcare costs in the past 12 months. Uninsured adults under 65 face even greater challenges, with 82%t reporting difficulty affording healthcare. Even among insured individuals, 40% worry about affording their monthly health insurance premiums, and 62% worry about affording their deductible before health insurance kicks in.

These numbers underscore the critical financial crisis that health insurance costs are imposing on Americans.

Paul’s Health Marketplace and Savings Accounts for All Act would go a long way toward fixing this dysfunctional system. The proposal would increase consumer choice by expanding Association Health Plans (AHPs) and bolstering the availability of tax-free Health Savings Accounts (HSAs). The expansion of AHPs would enable patients to group together as members of an association outside of traditional health insurance coverage, lowering costs for consumers through group buying power. Americans are members of countless groups, clubs and associations, but current policy only recognizes insurance as a vehicle for healthcare buying negotiations and leverage. More choices and buying power for consumers will result in more affordable options and more personalized coverage, allowing consumers to choose insurance that fits their needs and lifestyle and band together to demand better pricing.

AHPs offer a promising path away from the outdated model Americans use today, in which health insurance is usually tied to employment and offers limited options. This model is the source of frustration for millions but has been artificially bolstered by longstanding tax policies and red tape.

Rolling back the outdated Employee Retirement Income Security Act of 1974 regulations, which restrict Americans from banding to negotiate lower insurance prices, would be a monumental reform that would positively affect millions of Americans and lower costs. Imagine a world where Costco, Amazon or even a local gym membership could grant you access to affordable and diverse health insurance options through a dynamic market not controlled by an employer.

Additionally, Paul’s bill would expand HSAs, which offer tax advantages for healthcare expenses by allowing pre-tax contributions up to $4,400 for individuals and $8,750 for families with high-deductible health plans in 2026. Paul’s proposal would increase the maximum annual HSA contribution to $24,500 for 2026 and open HSAs to all Americans, instead of limiting access to HSAs based on insurance coverage or income level.

The bill would also expand HSA use and eligibility to gym memberships, wearable fitness trackers, and dietary supplements, allowing Americans to use their money to invest in preventive healthcare and lifestyles. By broadening contribution limits and eligible expenses, the legislation would give families meaningful financial flexibility at a time when premiums, deductibles and everyday health costs are squeezing household budgets.

Today, millions of Americans lack access to HSAs, a high-value savings tool that avoids Uncle Sam’s creeping hand. Casting a broader net to include all Americans, coupled with bolstering AHPs, would lower costs and expand healthcare choice. Patients deserve to feel empowered in their healthcare decisions, rather than relying on the federal government to bail them out. At a moment when premiums are rising and ACA subsidies are set to expire, the need for genuine market reform has never been clearer. The Health Marketplace and Savings Accounts for All Act is exactly what the doctor ordered.

Christina Smith is the director of the Taxpayers Protection Alliance’s Consumer Center/InsideSources