The "Fair Care Act of 2026" seeks to overhaul the U.S. healthcare system by focusing on affordability, competition, and transparency. Title I modernizes Health Savings Accounts (HSAs) by expanding eligibility to a wider range of health plans, including Medicare and Medicaid, and introducing tiered annual contribution limits based on actuarial value, with a $50,000 accumulation cap. It allows unused premium tax credits and rollovers from other health accounts into HSAs, while also requiring new corporations to utilize HSAs for employee health benefits and converting federal employee health plans to HSA deposits. Title II focuses on improving private health insurance. It reinstates guaranteed availability and prohibits discrimination based on preexisting conditions , contingent on the Affordable Care Act being struck down. The bill expands the definition of "employer" under ERISA to facilitate Association Health Plans (AHPs) and clarifies rules for short-term limited duration insurance. It establishes an Invisible Guaranteed Coverage Pool Reinsurance Program for high-cost individuals and repeals the employer health insurance mandate. Furthermore, it modifies premium tax credits, expanding eligibility to 600% of the poverty line and allowing individuals with employer-sponsored insurance to receive them, while capping the tax exclusion for employer-provided health coverage and adjusting age-based premium variations. Title III addresses competition, transparency, and accountability. It authorizes the Federal Trade Commission to investigate hospital consolidation and applies Medicare Advantage rates to certain hospitals in concentrated markets. The bill bans anticompetitive terms in facility and insurance contracts and provides antitrust exemptions for private insurers to jointly negotiate hospital service and prescription drug prices. Significant attention is given to price transparency , requiring hospitals and health plans to disclose standard charges and negotiated rates. For prescription drugs, it expedites generic complex drug development, prevents delays in generic approvals, and reduces brand-name biologic exclusivity from 12 to 5 years. It also introduces conditional and provisional approval pathways for drugs treating rare or serious diseases, with associated patient registries and reimbursement rules. Subtitle D of Title III specifically targets Pharmacy Benefit Manager (PBM) transparency , mandating that PBMs pass through 100% of rebates to health plans, prohibiting retroactive payment reductions to pharmacies, and imposing strict transparency requirements on PBMs regarding data sharing and ownership interests. Subtitle F introduces comprehensive medical malpractice reforms , including a 3-year statute of limitations, a $250,000 cap on non-economic damages, limits on attorney contingent fees, and provisions for periodic payment of future damages. It also limits liability for volunteer healthcare professionals and requires affidavits of merit and notice of intent to sue. Finally, Title IV implements Medicare and Medicaid reforms . For Medicaid, it introduces a reformed payment system for states based on beneficiary-based amounts, with chronic care quality bonuses, and limits federal payments for individuals above 100% of the federal poverty line, with specific exceptions. It also allows states greater flexibility in eligibility determinations and lowers the safe harbor threshold for state healthcare provider taxes. Medicare reforms include site-neutral payments for off-campus provider-based departments, elimination of FEHBP eligibility for Medicare annuitants, and the elimination of Medicare eligibility for high-income individuals. It also repeals the net investment income tax and increases Medicare coverage for bad debt. The bill establishes a "Unified Medicare" system with competitive bidding for enrollment in traditional fee-for-service, Accountable Care Organizations (ACOs), and Medicare Advantage plans, and sets an out-of-pocket limit for enrollees. Lastly, it significantly expands telehealth services coverage, including more providers and services, and allows for waivers of telehealth restrictions under certain conditions, particularly for mental health and emergency care.