A healthcare alternative built around ownership

Replace premiums.
Build your own balance.

The American Health Ownership Model brings together your own healthcare account, a Shared Care Fund for covered costs beyond your savings, a proposed legislative framework for pre-tax investment, and proposed income-tax relief. It replaces the standard private-insurance approach for participating working-age households. This is advocacy for legislative reform; no AHOM investment or coverage is offered.

Start with your household budget

A replacement.
A balance that belongs to you.

01

Replace the premium.

Redirect healthcare funding from standard private-insurance premiums toward your own account and the Shared Care Fund. AHOM is an alternative way to finance care, designed to put ownership at the center.

02

Keep the account.

Your contribution builds a balance you own. It funds care when you need it, while unspent money stays invested for your future. Your household sets money aside and retains ownership of what remains.

03

Change the tax bill.

AHOM calls for legislation eliminating federal income-tax liability for the bottom half of tax-filing households and creating pre-tax treatment for eligible contributions. Medicare and Social Security payroll taxes stay in place.

Find your household’s opportunity.

Your opportunity includes more than income-tax relief. Look at the premiums and medical bills you pay today, the support behind your current coverage, and the resources you could retain under AHOM. Even if you already owe no federal income tax, replacing premiums, seeking better value, and building an owned balance remain opportunities to explore. The mix will be different for each household.

See how household costs compare
Where the proposed contributions go

Your savings. Your Shared Care Fund.

Accounts can open at any age, including birth, and are locked against withdrawals until age 18. Families can contribute during childhood; earnings-based contributions begin when the participant earns income. Participation is voluntary. These starting rates direct money to personal savings and shared protection. The proposed annual contribution cap limits what you pay into the Fund for coverage; it does not set the Fund’s medical-benefit limits.

The starting proposal is 10% toward owned savings and up to 7% toward pooled protection, with a long-term target of 5% as pool finances allow. The annual dollar cap is part of the proposed design, with its amount still open. Proposed federal tax advantages for the HSA, protection payment, and optional investment are explained in the tax FAQ.

The Shared Care Fund: protection and peace of mind

The Shared Care Fund answers a central concern: how to pay for covered care that exceeds your savings. Members pool protection payments so covered costs can be paid after the personal account is exhausted, helping protect households against medical debt. Its payments do not become an overdraft debt you owe back.

Access to necessary care. A reason to seek value.

AHOM aims to keep necessary covered care within reach while giving participants a lasting reason to seek value. The personal account pays first; unspent money remains yours. The Shared Care Fund supports covered needs beyond the balance under the same published benefit terms, and additional investment creates a separate financial interest.

The proposed legislative framework would allow separate investment capital to support the Fund’s financing. That capital could build reserves and absorb losses when claims exceed operating income. Potential investor distributions would follow claims, expenses, and required reserves. There is no operating AHOM fund or investment opportunity today.

How this compares with conventional insurance

What happens when you need care?

You and your clinician choose appropriate care. You pay eligible expenses from your account. If covered medical needs exhaust it and you have purchased protection, the Shared Care Fund pays according to its published benefits and limits.

Two contributions serve two purposes: the account builds personal resources, and the Shared Care Fund adds protection after the balance is used.

The policy case for private capital

Shared protection.
Proposed investment incentive.

Income can grow without an endlessly rising bill for the same covered protection. The proposed annual contribution cap limits the amount a household pays for Fund protection. Covered benefits follow the same published terms across income levels.

Protection

7% of income, with a contribution cap.

The lower of the percentage payment and the annual cap buys Shared Care Fund coverage. The cap is on your payment, not a new limit on medical benefits.

Proposed capital framework

A proposed incentive for private capital.

If enacted and implemented, the proposed framework would permit eligible participants to invest separately above the protection-contribution cap, within an investment limit. Eligible contributions would reduce federal taxable income. Participation would be voluntary; no investment or current deduction is available through this site.

A reason to participate beyond paying bills

For a household able to self-fund routine care, AHOM proposes shared protection for covered bills beyond the HSA balance and access to negotiated prices. Separately, its capital framework could provide a share of distributable earnings for investors. The legislative goal is potential income outside the HSA, together with an upfront reduction in federal taxable income for eligible contributions. Investing more would create a financial interest, not a larger medical benefit.

The investment’s purpose is to pair private capital with potential personal returns. Claims, operating costs, and reserves take priority, with distributable earnings supporting investor payments. Explore the proposed tax advantages in the tax FAQ.

How the cap and investor returns fit together
Build beyond the next bill

Make saving part of healthcare.

Each contribution adds to an asset you own. Healthcare payments reduce it; unspent funds and investment returns can help build it. The longer funds remain invested, the more time they have to compound.

AHOM’s personal account emphasizes a conservative investment approach and a long horizon, giving retained savings time to work toward future healthcare needs.

An incentive that stays with you

When you choose a lower-priced appropriate service or avoid unnecessary care, the money you retain remains available for your future needs. That creates a tangible benefit from seeking value.

An additional member dividend could share audited Shared Care Fund surpluses after claims, operating costs, and required reserves are funded. Dividends would be conditional, with rules designed to protect preventive and necessary care.

Build a legacy for your family

AHOM includes inheritance reform designed to carry remaining healthcare savings into the next generation. The FAQ explains how this differs from current HSA beneficiary rules.

Personal savings and shared protection work together: the account funds care first, and the Shared Care Fund supports covered needs beyond the balance. The wealth-building opportunity comes from the funds you retain and their investment performance over time. Explore how healthcare use affects retained wealth.

A clearer relationship with care

See the price.
Make the decision.

For eligible care paid from your account, AHOM would let you spend your own funds without insurer medical-necessity approval. Clinical judgment stays with you and your healthcare professionals, while qualified-expense and fraud rules still apply.

Prices people can actually use

Participating providers would present understandable prices for planned care, including expected facility and professional charges and clearly identified exclusions. Shared Care Fund representatives would negotiate accessible provider prices, available to participants paying from their accounts as well as the pool.

For emergencies, AHOM combines negotiated billing protections with published coverage terms, supporting patients when comparing providers is impractical.

Separate purchasing from investing

The Shared Care Fund would pool risk and negotiate payment, functions that are still needed when costs exceed personal savings. Its investment management would be kept separate from provider purchasing, with a focus on diversified investments rather than ownership stakes in the hospitals it negotiates with.

Under the proposed framework, optional investment capital would be distinct from protection payments. Potential distributions would belong to the investor outside the HSA and be usable beyond medical expenses. Federal tax-free growth and distributions are additional legislative proposals; pre-tax contributions alone do not establish that treatment. No AHOM investment, deduction, or tax-free distribution is currently available. Explore how the optional investment works, including its risks.

Why consider a different approach?

Put ownership into the equation.

The current system

Today’s system combines employer insurance, individual coverage, Medicare, Medicaid, and direct patient payments. Some people already build wealth through HSAs. AHOM would make personal healthcare accounts central to participation rather than an option attached to certain insurance arrangements.

Medicare for All

M4A proposals broadly replace most existing coverage with a publicly financed benefit. They do not create a personally owned healthcare balance through that coverage. They can protect household finances by paying covered medical bills; whether a household has more money left over depends on the taxes paid and the premiums and expenses replaced.

Changing the payer does not remove the resources needed to deliver care. Claims about savings must account for administration, provider payments, benefit scope, and increased use. Hospital viability and available capacity remain essential questions. MedPAC reports negative aggregate hospital Medicare margins, while CBO’s illustrative single-payer analysis identifies the risk of demand increasing faster than supply. Neither finding alone determines the outcome of every M4A design. See the sources below.

The AHOM approach

AHOM combines direct ownership of healthcare savings with separately purchased protection. Its financial incentive is explicit: money not needed for care remains yours. Transparent prices make that incentive more useful, and direct account payments can reduce insurer involvement in treatment decisions.

AHOM brings personal control, an opportunity to accumulate resources, and shared protection into one proposed model. Its appeal extends beyond paying today’s bills to what healthcare saving can build for tomorrow. Explore the household comparison.

Questions & answers

A closer look.

Is AHOM an insurance plan I can join today?

No. Nothing described as an AHOM account, fund, coverage product, or investment vehicle exists yet. This site launches a policy idea only. There is no enrollment, investment solicitation, actionable coverage offer, or payment collection. Do not cancel existing coverage or move money based on it. Read the full idea-only notice.

How does the Shared Care Fund protect against medical debt?

For participating people who purchase protection, the Fund pays covered medical costs after the personal account is exhausted, according to the Fund’s benefits and terms. It shares those eligible costs across members rather than turning them into a personal overdraft loan. The aim is peace of mind when covered care is more expensive than personal savings.

The protection applies to eligible expenses under published coverage terms. It does not erase existing medical debt or promise payment of every possible service. The contribution cap limits the payment for coverage; benefit scope and any coverage limits are separate.

How is the Shared Care Fund different from conventional insurance?

Its proposed design brings together shared protection, an owned personal account that pays first, published negotiated prices, and a separate pre-tax investment opportunity. The contribution formula remains 7% of income during the transition, up to the proposed annual cap, with a long-term target of 5% as finances allow. The account supports direct payment for eligible care, and the Fund pays covered costs beyond the balance. Investing more does not buy a larger medical benefit.

The Fund still performs insurance functions: pooling risk, setting coverage terms, paying eligible claims, and holding capital against losses. Conventional insurers also invest assets and use capital. Investment alone is not the distinction, and calling this a Fund does not establish a legal exemption from insurance rules. AHOM’s case rests on the combined design and ownership incentives.

Can investment capital finance a shortfall?

Yes. Capital committed to the financing business can support reserves and absorb losses, subject to the structure’s rules. This gives the Fund another layer of resilience when covered claims exceed available income. Capital used to absorb a loss reduces the investor’s remaining interest; it is not simultaneously retained as an unchanged personal balance.

A continuing mismatch between claims and recurring revenue uses up capital over time. Long-term protection therefore depends on adequate contributions, explicit funding for any assistance, sustainable expenses, and sufficient reserves. Investment earnings and new investor contributions are uncertain. AHOM does not assume an unlimited supply of new capital to pay existing obligations or distributions.

Investor distributions follow claims, expenses, and required reserves. Capital at risk may be lost entirely. This is why the design accounts separately for recurring protection payments, investor capital, member surplus distributions, and investment earnings.

How does AHOM encourage prudent use and accountable spending?

Participants retain unspent personal-account funds, so choosing good value benefits their own future. Published prices support informed decisions with clinicians. Preventive and necessary care remain part of responsible use; the goal is appropriate care rather than simply fewer services.

The Shared Care Fund pays eligible claims under published benefit rules. AHOM’s design calls for provider and expense verification, independent financial audits, adequate reserves, and public reporting of claims, operating expenses, investment results, and distributions. Extra investment creates a separate investment interest rather than permission to charge personal spending to the Fund. Investor returns and member surplus distributions follow claims and reserve obligations.

What makes this worth considering if I have little money to set aside?

The starting benefit is protection alongside ownership. Under the proposed design, someone who purchases Shared Care Fund protection can receive payment for covered costs beyond the personal account before accumulating years of savings. An initial balance of zero does not itself create a waiting period for purchased protection.

That does not solve the contribution budget by itself. Compare the proposed account contribution and protection payment with the premiums and medical costs actually replaced, your taxes, employer support, and assistance you qualify for. AHOM retains Medicaid for qualifying needs and temporary hardship. The site does not claim that Medicaid automatically pays every low-income participant’s contributions or that households with little cash can already afford the starting rates.

A credible rollout needs a funded affordability path for people whose contributions and eligible assistance are insufficient. That is a substantive financing question, not a benefit created by changing the wording of the pitch.

Why switch if my employer already provides good insurance?

The proposed gain is a healthcare asset that stays yours across jobs, direct payment for eligible care, shared protection after the account runs out, and a path for remaining savings to benefit your family. Today’s HSAs already provide ownership and portability; AHOM makes the account central to the broader financing model and adds its proposed inheritance and separate investment reforms.

The comparison must preserve the value of what your employer pays today. Ending an employer premium does not automatically transfer that amount to your paycheck or account. Compare household cash requirements, employer support, covered benefits, provider access, and your likely medical needs. A heavily employer-funded plan could be financially better for a particular household, especially without a concrete arrangement for redirected employer resources.

AHOM’s pitch is an opportunity to connect healthcare funding with lasting personal ownership. It is not a claim that every worker should give up current coverage or would come out ahead.

What policy incentive would private capital receive?

Protection and investing answer different questions. A capped protection payment transfers covered risk beyond the HSA balance. Optional pre-tax capital buys a separate investment interest in the financing business, with potential income outside the HSA and proposed tax advantages. It is a choice to participate in the economics of shared care, rather than an endlessly rising payment for the same medical benefit.

A skeptical investor still needs to compare this with other investments. Fees, governance, investment policy, capital commitments, liquidity restrictions, audited accounts, and the priority of claims and reserves all affect the result. Returns must come from distributable earnings after obligations, not merely new investors’ contributions. Proposed tax benefits are not evidence of a competitive return, and the investment can lose its entire value.

There is no operating AHOM fund, investment offer, audited performance record, or selected contribution cap today. This website explains the policy idea, not an investable product.

How can I compare AHOM with my current household costs?

Start with your full picture: employee premiums, out-of-pocket care, employer support, taxes, and public assistance. Compare those with AHOM’s account contribution and protection payment, any applicable tax relief, and the balance you retain. This reveals opportunities beyond a tax deduction alone. Some households could pay more, depending on their circumstances; an owned contribution still requires cash even though unspent funds remain an asset.

Employer-paid premiums are part of today’s healthcare financing, but ending them does not automatically put the same amount in your paycheck or HSA. The proposal gives employers room to support accounts, compensation, or business investment; no universal wage pass-through is assumed. Households currently receiving highly subsidized coverage may need continuing assistance to participate affordably. During the transition, temporary overlap with existing coverage is possible; this site does not establish a household enrollment schedule or a final funding plan.

How does the proposed Shared Care Fund contribution cap work?

The proposed protection payment is the lower of 7% of income and a published annual dollar ceiling for the applicable coverage tier. The percentage target is 5% as finances allow. The ceiling does not buy a smaller benefit for higher earners, and investing extra does not increase medical benefits. No dollar cap has been chosen. Individual and family coverage must be priced consistently with the obligations they create.

The cap lowers contributions from high earners relative to an uncapped percentage. Its level must be tested against expected covered claims, expenses, reserves, transition needs, and voluntary enrollment. Any necessary support for income-based contributions below sustainable coverage costs must have an explicit funding source. Optional investment capital cannot be assumed to fill a recurring premium shortfall.

Under the proposed legislation, a participant choosing to keep setting aside 7% of income could separately invest the amount above the contribution cap pre-tax, within the proposed investment contribution limit. This requires an affirmative investment choice; otherwise the participant keeps that money. This is a policy design proposal, not a funded or actuarially validated benefit schedule.

Is this an investment offer or an existing tax benefit?

No. This website advocates a healthcare policy idea and changes to federal law. There is no AHOM issuer, operating fund, security, investment subscription, or account available here. The site accepts no money, indications of investment interest, reservations, or investment commitments, and it does not recruit participants for a future offering.

Pre-tax contributions, the bottom-50% federal income-tax exemption, new inheritance treatment, and proposed tax-free investment distributions are legislative proposals, not instructions for a current tax return. Existing HSA tax benefits continue to depend on current law and eligibility. Do not transfer funds or claim an AHOM tax benefit based on this site.

Any future program or financial product would be a separate undertaking requiring its own legal framework, disclosures, applicable approvals or exemptions, and operating arrangements. This site makes no promise that such a program will be enacted or launched.

How does the proposed pre-tax Shared Care Fund investment reduce taxes?

AHOM proposes allowing eligible optional investment contributions to be excluded from current federal taxable income or deducted, within a separate annual investment limit. A contribution would receive one tax benefit, not both an exclusion and a second deduction. The protection-payment ceiling and the investment contribution limit serve different purposes; neither dollar limit has been selected.

This is an income reduction, not a dollar-for-dollar tax credit. Any current tax saving depends on the taxable income displaced and the applicable marginal tax rate. Someone who already owes no federal income tax may receive no immediate federal income-tax benefit. No exemption from Social Security or Medicare payroll taxes, or from state income taxes, is implied.

Tax savings and investment returns are separate. The upfront tax treatment does not make the investment profitable or protect its principal. Pre-tax contributions alone also do not establish tax-free growth or withdrawals; those are additional tax preferences included in AHOM’s proposed framework, not consequences of the word “pre-tax.” None of these AHOM benefits exists under current law.

The proposed investment gives households an additional reason to supply risk capital. Its tax preferences also reduce government revenue compared with an otherwise identical taxable investment; that fiscal cost belongs in the proposal’s funding analysis. The design does not count tax savings as new revenue for the Shared Care Fund.

Where would investor returns come from?

Optional pre-tax capital would buy a defined investment interest in the Shared Care Fund financing business, separate from a participant’s payment for coverage. Pre-tax treatment is a proposed legislative benefit; it does not exist for an AHOM investment today. Returns would depend on distributable net earnings from protection operations and investment activity, after expenses, claims, required reserves, and applicable capital protections. Income would follow the investment interest held; it would not be a refund of the coverage payment or a guaranteed dividend.

Capital supports resilience and absorbs losses. It cannot simultaneously be promised back to investors on demand and treated as freely available permanent funding for care. Losses can reduce the investment to zero, and distributions or redemptions can be restricted. Investor returns and member surplus dividends would share the same finite distributable surplus under disclosed allocation rules; the model does not count that surplus twice.

The general principle of matching capital to risk is described by the NAIC. That guidance does not validate AHOM’s cap or financing. The final legal structure would determine the applicable insurance, securities, and tax rules.

Can parents start an account before a child turns 18?

Yes. AHOM proposes accounts from birth or any later age. Parents and other family members can contribute before the child reaches 18. Withdrawals begin at 18 and remain subject to qualified-use rules; turning 18 does not turn the HSA into unrestricted spending money.

The pre-18 balance is set aside for adulthood. Childhood medical care uses separate coverage or payment arrangements rather than withdrawals from this locked account. The account is not an existing financial product and cannot be opened through this site.

Does locking the account until 18 mean higher returns?

It gives early contributions more time to compound before withdrawals and creates a known period without account withdrawals. That can help managers plan longer-term investments and liquidity. AHOM can explore term-based investment options suited to that horizon, with assets available as withdrawal eligibility approaches.

A withdrawal restriction does not by itself produce earnings or guarantee a higher rate. Investment results, fees, and market conditions still matter. Longer-duration and less-liquid assets can carry additional risk, and children opening accounts closer to 18 have a shorter investment horizon. AHOM does not promise a fixed return or exchange its conservative account objective for a guaranteed-return claim.

How is AHOM different from an HSA I can open today?

Today’s HSA already provides personal ownership, investment options, tax advantages, and portability. AHOM does not claim to invent those features or promise better investment returns. The proposed change is the system around the account: accounts funded at any age with withdrawals beginning at 18, direct account payment as the primary funding method, transparent negotiated prices, and a separately funded Shared Care Fund that begins after account exhaustion.

AHOM adds proposed reforms beyond today’s HSA: a framework for preserving remaining healthcare wealth across generations and an optional, separate investment offering potential income usable outside healthcare. Its proposed tax framework and income-tax relief are policy changes, not benefits currently available through AHOM. Existing HSA eligibility and contribution limits remain in force today.

Is AHOM an add-on to my current insurance?

No. AHOM is a proposed alternative to the standard insurance-first approach for participating working-age adults, not another account added on top of the same employer insurance arrangement. Personal savings pay eligible expenses first; the separately funded Shared Care Fund covers eligible needs after those savings are exhausted. The transition retains Medicare for older adults and Medicaid for qualifying needs. The Shared Care Fund still pools risk and administers coverage, so AHOM does not eliminate every insurance function.

Would the proposed framework allow returns outside the HSA?

That is the aim of the proposed legislation, not an opportunity available today. If enacted and implemented, a separate Shared Care Fund financing framework could allow private capital to earn potential dividends or other distributions. Those payments would belong to the investor outside the HSA, available for personal spending, saving, or reinvesting rather than restricted to qualified medical expenses. The ordinary Shared Care Fund payment—7% of income up to the proposed annual cap—would not purchase an investment or create a right to investor returns. This is a hypothetical structure, not an investment opportunity available today.

The optional investment would carry higher risk than the conservative approach envisioned for personal HSA balances. Distributions would depend on investment results, claims, capital requirements, and the final legal structure; neither payment amounts nor access to capital on demand are promised. An investor could lose the entire investment. Member surplus dividends are a separate proposed feature, not the same as investor distributions.

What does “tax-free” mean in this proposal?

For the personal HSA, AHOM proposes pre-tax or deductible contributions within a cap, federal income-tax-free investment growth, and federal income-tax-free withdrawals for qualified medical expenses. For the Shared Care Fund, the proposal seeks pre-tax treatment of the protection payment and of eligible optional investment contributions within a cap, plus federal income-tax-free growth and distributions from the optional investment vehicle. These are intended legislative features, not tax benefits available through AHOM today. They do not imply exemption from payroll taxes or state taxes.

The 7% protection payment remains a payment for coverage, even if deductible or made pre-tax; it is not an asset you own. Optional investment capital would be accounted for separately. Tax-free treatment for investment income usable outside an HSA would require a new legal framework. Existing law does not automatically grant it to an insurance-related investment, and an investment loss does not automatically qualify for a tax deduction.

Under current federal HSA rules, eligible contributions receive tax advantages, earnings can accumulate tax free, and qualified medical distributions are tax free. Nonqualified withdrawals generally have different tax consequences. Current contribution limits, eligibility, and beneficiary rules still apply; AHOM has not changed them. Read the current IRS rules.

Would inheritance preserve the account’s tax advantages?

AHOM’s goal is to allow remaining healthcare wealth to benefit future generations under new inheritance rules. A tax-preserving family transfer would require legislation; it cannot be assumed under today’s rules. Currently, a surviving spouse who is the designated HSA beneficiary can generally treat it as their own HSA. For a nonspouse beneficiary, the account generally ceases to be an HSA and its value is generally taxable, subject to the applicable rules and adjustments.

How does healthcare use affect the wealth my family can inherit?

Medical expenses, investment losses, fees, and any applicable taxes can reduce or exhaust the balance. A major illness may use the entire HSA before the Shared Care Fund begins paying covered expenses. The Shared Care Fund would not restore savings already spent. Inheritance applies only to whatever remains under the eventual rules.

How should I read the comparison between systems?

The comparison describes financing structures, not a forecast of household costs or proof that every household would accumulate more wealth. Existing HSAs can already build individually owned healthcare savings. Households can save and invest separately under the current system or M4A. AHOM’s distinction is making an owned healthcare account central to participation, paired with separate protection and the proposed optional investment mechanism.

Is the account illustration a forecast?

No. The artwork communicates the goal of building resources over time. It shows no actual account, historical results, expected growth rate, or promised return. Whether an account grows depends on contributions, medical spending, investment results, and fees.

Are both contributions money spent?

No. Under the starting proposal, 10% goes into your personally owned healthcare account. Depositing that money transfers it into your asset; spending it on care reduces the asset. The separate Shared Care Fund payment is 7% of income up to the proposed annual cap; it buys pooled protection and does not build a personal balance. Any optional investment above the cap is a different asset with its own risk. These percentages do not replace the Medicare payroll taxes retained in the proposal.

What if I get seriously ill before building savings?

If you have purchased the Shared Care Fund, covered expenses would be paid after your account runs out, subject to the pool’s published terms. The design intends that protection to be available before someone has decades of savings. The design pairs early protection with pool reserves and transition funding.

What about existing conditions or long-term illness?

The proposed Shared Care Fund is intended to protect participating people whose covered needs exceed their balances, including serious illness. Medicaid would remain available for qualifying needs. Published eligibility criteria, benefits, and limits define the protection. Coverage is not unlimited.

What happens if I lose my job or income?

Your existing account remains yours. The proposal would use Medicaid for qualifying temporary hardship, with income and eligibility checks and periodic review. It would also retain assistance for people whose needs are not temporary and who qualify under the applicable rules.

How do early accounts work for college students and young workers?

Both groups can enter adulthood with family-funded balances accumulated before 18. From age 18, qualified healthcare withdrawals become available. Earnings-based contributions follow income, so a full-time worker may contribute more than a student with limited earnings. Childhood gifts and investment results also affect balances; the model does not assume every young adult starts with the same savings.

What happens to Medicare and payroll taxes?

Medicare for adults 65 and older would remain during the transition. The proposal retains existing Medicare and Social Security payroll taxes. AHOM’s personal account and Shared Care Fund contributions would not eliminate those taxes.

What income-tax relief is proposed?

The proposal would eliminate federal income-tax liability for the bottom half of tax-filing households, using the filing household rather than each adult as the unit. This would not eliminate payroll taxes, and households already owing little or no federal income tax would receive correspondingly little direct relief. Eligibility is based on the tax-filing household; the proposal’s tax relief is a legislative policy change, not a current tax exemption.

Would employer savings become higher wages?

Moving away from standard employer insurance premiums could free resources for compensation, hiring, and business investment. Some resources could move into wages, but that pass-through would not be automatic or guaranteed.

How does AHOM reward value while supporting necessary care?

The core incentive is retaining unspent funds. AHOM should support prevention and appropriate treatment, not encourage delaying care that protects health. The proposed surplus dividend protects preventive and necessary care in its eligibility rules. There is no guaranteed annual bonus.

How can investment earnings support the Shared Care Fund?

Investment earnings could support the pool, but they cannot be assumed to cover claims or produce guaranteed investor returns. Protection contributions and optional investor capital would be accounted for separately, with claims and reserve obligations protected. Optional investors would accept investment risk, including possible loss of capital.

How would AHOM address fraud and accountability?

AHOM’s design includes provider verification, billing checks, audits, and penalties for misuse. Public Shared Care Fund reporting covers claims, operating expenses, investment performance, reserves, and distributions. Direct payment is intended to simplify care, while retaining controls against false or ineligible expenses.

What shapes AHOM’s wealth-building opportunity?

AHOM connects personal ownership with incentives to seek value. Contributions, family funding, medical spending, time, investment results, and fees all shape the retained balance. The opportunity is to build resources while funding care. Wealth and lower costs are not guaranteed, and the starting rates remain a policy proposal rather than an actuarially validated schedule.

Read the underlying material

Sources & context.

Explore the research and current rules behind the discussion. These independent sources provide context; AHOM’s design and proposed rates are the author’s policy ideas, not endorsements by the cited organizations.

  1. MedPAC: Hospital inpatient and outpatient services, March 2026. Reports hospital finances and Medicare payment adequacy. Aggregate fee-for-service Medicare margin was −12.1% in 2024, excluding relief funds.
  2. CBO: Analysis of illustrative single-payer systems, 2020. Examines administration, provider payments, utilization, capacity, and spending. These scenarios are not a score of the current M4A bill.
  3. CBO: Commercial and Medicare provider prices, 2022. Distinguishes Medicare payment shortfalls from evidence about commercial pricing and cost shifting.
  4. H.R. 3069: Medicare for All Act, introduced April 2025. Includes benefits, no patient cost-sharing, provider payments, budgeting, and anti-fraud provisions.
  5. IRS Publication 969. Explains current HSA rules, including beneficiary treatment. AHOM would require changes to existing law.
  6. CMS: FY2025 improper payments. Explains payment-integrity estimates; improper payments are not a measure of fraud.
Bring ownership into the conversation

A different way to think
about healthcare.

Share the idea of personal savings, patient control, and protection when it matters.