Thom Tillis

Extends the enhanced Affordable Care Act premium tax credits through 2028. Monthly premiums stay lower for people who buy their own coverage on the marketplace.

The Senate Republicans' alternative. Instead of subsidizing insurers, the government puts cash into people's Health Savings Accounts, plus cost-sharing help, for those on bronze, catastrophic, and silver plans.

Makes the enhanced ACA premium tax credits permanent. More people qualify for marketplace subsidies, and the subsidies stay larger, for good.

Reins in the pharmacy benefit managers who sit between drugmakers and pharmacies. It curbs tactics like “spread pricing,” requires PBMs to pass manufacturer rebates through to health plans, and unlinks their pay from a drug's list price.

Compares brand-name drug prices against what five peer countries pay. If a U.S. price is judged “excessive,” the government strips the drug's market exclusivity and licenses generic competitors to force the price down.

Replaces private health insurance with a single government-run program that covers everyone. There are no premiums or deductibles for covered care.

Repeals the Medicaid, Medicare, and health-tax provisions of the 2025 reconciliation law, and makes the enhanced marketplace premium tax credits permanent.

Cancels the 2025 federal rule that shortened the window to sign up for marketplace coverage and added paperwork checks before people can enroll outside it.

Cancels money Congress has already approved. The 2025 version clawed back about $9 billion, mostly from foreign aid and public broadcasting, and was signed into law.

Repeals the 1974 law that bars a president from refusing to spend money Congress has appropriated. It would let the president “impound” funds, that is, decline to spend them, to hold down federal outlays.

Creates a bipartisan commission of lawmakers and outside experts to write a plan to stabilize the debt, with a guaranteed up-or-down vote in Congress. It doesn't choose the spending cuts or tax increases itself; it forces a process to decide.

Adds an extra tax on income above roughly $1 million a year, on top of the existing rates.

Taxes the yearly rise in the value of billionaires' assets, such as stock, even before they are sold. Today those gains are taxed only when the asset is sold, if ever.

Levies a yearly tax on net worth above $50 million, a small percentage of a household's total wealth rather than its income, rising for billionaires.

Requires a background check for nearly all firearm sales, including private transfers between individuals. Today only licensed dealers must run the check; sales between private parties are generally exempt.

Sets a federal safe-storage standard: firearms in a home where a minor could reach them must be locked or otherwise secured, with penalties when an unsecured gun is accessed. It is named for a teenager killed by an unsecured firearm.

Raises the minimum age to buy certain semiautomatic rifles and shotguns from a licensed dealer from 18 to 21. Handgun sales from dealers already carry a 21-and-older minimum.

Bans the manufacture, sale, and import of many semiautomatic rifles and pistols the bill defines as “assault weapons,” along with the large-capacity magazines it defines. Firearms already owned are grandfathered in.

Funds and creates a federal extreme-risk protection order: a court process letting police or family members ask a judge to temporarily remove firearms from a person found to be a danger to themselves or others.

Requires every state to honor concealed-carry permits issued by any other state, so a permit valid in one state would let its holder carry a concealed handgun in all of them, overriding stricter local carry rules.

Removes firearm suppressors (“silencers”) from the National Firearms Act, ending the federal registration and extra screening that buying one now requires. They would be sold like ordinary firearm accessories.

Repeals the 2005 law that shields gun makers and dealers from most lawsuits over crimes committed with the guns they sell, and opens the federal firearm-trace data to the public.

Bars the Department of Veterans Affairs from sending the names of veterans it has found unable to manage their own financial affairs to the NICS background-check database. Today that VA finding alone can bar a veteran from buying a gun.

Sets a fee on imported steel, cement, and other heavy industrial goods based on how much carbon pollution it took to make them, and holds American producers to the same standard.

Speeds up environmental reviews for forest-thinning and controlled-burn projects on federal land, and sets up a joint federal center to coordinate wildfire work. The House passed it in 2025.

Puts the Nuclear Regulatory Commission on a deadline when it licenses the plants that make and recycle fuel for advanced reactors, the step that currently holds up new reactors.

Cancels the federal permission that let California require carmakers to sell a rising share of zero-emission vehicles, a standard more than a dozen other states had adopted. It passed both chambers and was signed into law in 2025.

Kills the federal charge that made oil and gas companies pay for the methane they leak or vent into the air, a fee created by the 2022 climate law. It passed both chambers and was signed into law in 2025.