Bill
S. 3386 (119th): A bill to provide a health savings account contribution to certain enrollees, to reduce health care costs, and for other purposes.
A bill to provide a health savings account contribution to certain enrollees, to reduce health care costs, and for other purposes.
Summary
Recorded summary
The bill directs HHS to deposit $1,000 or $1,500 annually into HSAs in 2026-2027 for enrollees aged 18-64 with bronze or catastrophic exchange plans and income up to 700% FPL. Beginning in 2027, it funds cost-sharing reductions for silver-plan enrollees with income up to 250% FPL, and it allows any individual to enroll in a catastrophic plan. It reduces the enhanced Medicaid expansion matching rate for states that provide health benefits to certain non-qualified noncitizens, makes Medicaid and CHIP coverage optional during immigration status verification, and conditions federal payment on that verification. It bars exchange plans from covering gender-transition procedures as an essential health benefit and bars federal Medicaid and CHIP payment for those procedures.
Theological note: The bill raises issues of stewardship of the body and health care resources, care for the poor and sick through affordability measures, and the treatment of sojourners in public benefit programs, which call for both mercy and public order. Its restriction on federal funding for gender-transition procedures touches on the created order of human embodiment and on the duty of government not to subsidize practices that distort it. These are issue points for review, not a final candidate judgment.
Scoring
How this bill is scored
- Tier: no Tier 1 record. A bill with no record cannot newly become Tier 1.
- Lane: gender_transition. Category: not stored. Lane tag: not stored.
- Lane: health_policy. Category: not stored. Lane tag: not stored.
- Lane: medicaid_eligibility. Category: not stored. Lane tag: not stored.
- Lane: noncitizen_benefits. Category: not stored. Lane tag: not stored.
- Lane: practical_good. Category: not stored. Lane tag: not stored.
- Tier 1 sign-off: no record. A bill with no record cannot newly become Tier 1.
- Stored polarity: mixed. Only tags the rules mark scoreable on a mixed bill are scored. A yea can draw a penalty or a credit according to the tag. A nay on a tag scored as good can draw a penalty.
- Roll 643: On the Cloture Motion S. 3386. Vote type: cloture.
- Polarity rationale: Reviewed enrichment (llm_import) polarity: The bill combines prudential health-affordability measures (HSA deposits, cost-sharing reductions, catastrophic plan access) with a provision that restrains federal funding for gender-transition procedures, which may be read as restraining a harm. Its noncitizen eligibility and verification changes are prudential disputes about benefit policy. The title and summary give enough to classify it as mixed without hard moral verdict.
- Theological note: The bill raises issues of stewardship of the body and health care resources, care for the poor and sick through affordability measures, and the treatment of sojourners in public benefit programs, which call for both mercy and public order. Its restriction on federal funding for gender-transition procedures touches on the created order of human embodiment and on the duty of government not to subsidize practices that distort it. These are issue points for review, not a final candidate judgment.
Debt and war Cloture and Tier 1 Procedural votes Scoring mechanics
Roll
Recorded votes
Roll 643 · December 11, 2025, 11:45 AM · On the Cloture Motion S. 3386 · Cloture Motion Rejected (51-48, 3/5 majority required)
Yea
- BANKS, JAMES E. HON.
- BARRASSO, JOHN A
- BLACKBURN, MARSHA MRS.
- BOOZMAN, SEN. JOHN
- BRITT, KATIE BOYD
- BUDD, THEODORE P
- CAPITO, SHELLEY MOORE
- CASSIDY, WILLIAM M.
- COLLINS, SUSAN M.
- CORNYN, JOHN SEN
- COTTON, THOMAS
- CRAMER, KEVIN MR.
- CRAPO, MICHAEL D
- CRUZ, RAFAEL EDWARD TED
- CURTIS, JOHN
- ERNST, JONI K
- FISCHER, DEBRA S.
- GRAHAM, LINDSEY O.
- GRASSLEY, CHARLES E
- HAGERTY, BILL
- HAWLEY, JOSHUA DAVID SEN
- HOEVEN, JOHN
- HUSTED, JON
- HYDE-SMITH, CINDY
- JOHNSON, RON HAROLD MR.
- JUSTICE, JAMES CONLEY II
- KENNEDY, JOHN NEELY
- LANKFORD, JAMES PAUL
- LEE, MIKE
- LUMMIS, CYNTHIA MARIE MRS.
- MARSHALL, ROGER W
- MCCONNELL, MITCH
- MCCORMICK, DAVE
- MOODY, ASHLEY
- MORAN, JERRY
- MORENO, BERNIE
- MULLIN, MARKWAYNE
- MURKOWSKI, LISA
- RICKETTS, PETE
- RISCH, JAMES E MR.
- ROUNDS, MIKE
- SCHMITT, ERIC
- SCOTT, RICK SEN
- SCOTT, TIMOTHY E.
- SHEEHY, TIM
- SULLIVAN, DAN
- THUNE, JOHN R.
- TILLIS, THOM R SEN
- TUBERVILLE, THOMAS H
- WICKER, ROGER SEN.
- YOUNG, TODD CHRISTOPHER
Nay
- ALSOBROOKS, ANGELA
- BALDWIN, TAMMY
- BENNET, MICHAEL F.
- BLUMENTHAL, RICHARD
- BLUNT ROCHESTER, LISA
- BOOKER, CORY A.
- CANTWELL, MARIA
- COONS, CHRISTOPHER A.
- CORTEZ MASTO, CATHERINE
- DUCKWORTH, L. TAMMY
- DURBIN, RICHARD J.
- FETTERMAN, JOHN KARL
- GALLEGO, RUBEN
- GILLIBRAND, KIRSTEN
- HASSAN, MARGARET WOOD
- HEINRICH, MARTIN
- HICKENLOOPER, JOHN W.
- HIRONO, MAZIE K.
- KAINE, TIMOTHY MICHAEL
- KELLY, MARK
- KIM, ANDY
- KING, ANGUS S. JR.
- KLOBUCHAR, AMY
- LUJAN, BEN RAY
- MARKEY, EDWARD SEN.
- MERKLEY, JEFFREY ALAN
- MURPHY, CHRISTOPHER S
- MURRAY, PATTY
- OSSOFF, T. JONATHAN
- PADILLA, ALEX
- PAUL, RAND
- PETERS, GARY
- REED, JOHN F.
- ROSEN, JACKY
- SANDERS, BERNARD
- SCHATZ, BRIAN
- SCHIFF, ADAM
- SCHUMER, CHARLES E.
- SHAHEEN, JEANNE
- SLOTKIN, ELISSA
- SMITH, TINA
- VAN HOLLEN, CHRIS
- WARNER, MARK ROBERT
- WARNOCK, RAPHAEL
- WARREN, ELIZABETH
- WELCH, PETER
- WHITEHOUSE, SHELDON
- WYDEN, RONALD L.