US SB3264

Creates a "Health Freedom Waiver Program" allowing states to waive ACA requirements including exchange standards, cost-sharing reductions, premium tax credits, and the individual mandate, effective for plan years beginning January 1, 2026, provided states maintain an invisible high-risk pool

Establishes "Trump Health Freedom Accounts" to receive federal funds equivalent to what residents would have received in premium tax credits and cost-sharing reductions, calculated based on national average silver plan premiums, with payments made monthly, quarterly, or annually at the resident's option

Prohibits use of Trump Health Freedom Account funds to pay for health plans covering gender transition procedures or abortion services, with detailed definitions of restricted procedures including puberty blockers, hormone therapy, and various surgical interventions

Expands small business health insurance tax credits in waiver states to 50% for all eligible employers with up to 50 employees, removes the phaseout provision, and eliminates the 2-year credit period limitation

Requires HHS, Treasury, and Labor Secretaries to update healthcare price transparency regulations within 90 days to mandate disclosure of actual prices (not estimates), standardized comparable pricing information, and public reporting of provider outcomes data