HEALTH5 is a proposal, not current law. This site makes the case for Congress to enact it. What lawmakers would vote on.
OnePayerSystem

One card. Five kinds of care. Any qualified doctor.

A proposal for Congress

HEALTH5 is proposed federal legislation. If enacted, it would cover medical, dental, vision, hearing and prescription drugs for every qualified American, for a standard contribution of $125 a month.

What Congress would vote onSee the plan

Five benefits under one card

Today, most families juggle a medical plan, a dental plan, a vision rider and a drug formulary, if they have them at all. HEALTH5 would put all five in one core benefit.

Medical

Preventive, diagnostic, hospital, physician, emergency, mental-health, surgical and rehabilitative care.

Dental

Dental care as part of the core benefit, not a separate policy most families go without.

Vision

Eye care included in the same coverage, with the same card.

Hearing

Hearing care, including the services people now postpone because of cost.

Prescriptions

Outpatient prescription drugs, backed by national purchasing leverage.

Same doctor visit. Far fewer steps.

Most of the cost and frustration in American health care happens after the visit, in the paperwork that decides who pays and how much. HEALTH5 would replace that maze with one standard transaction. CMS itself says that when transactions are standardized, “the industry can automate many of its billing and payment processes” (CMS, Administrative Simplification).

Today 8 checkpoints

  1. Verify which plan you haveCoverage changes with every job
  2. Check whether the doctor is in network
  3. Get prior authorization
  4. Match the plan’s private contract rate
  5. Apply deductible and coinsurance
  6. Deny, then appeal
  7. Coordinate benefits between plans
  8. Bill the patient the balance

Under HEALTH5 one path

  1. Covered person
  2. Covered service
  3. Any qualified providerNo insurer networks for covered care
  4. Standard electronic claim
  5. Standard, geographically adjusted rate
  6. Payment in fullBalance billing would be prohibited

$832 a month, shared

HEALTH5 sets a national ceiling of $832 per covered person per month in total funding, matching the Central States benchmark (see Research). You would pay $125. The other $707 would come from your employer, from health dollars governments already spend, or a combination.

$1,500 a year from you$9,984 a year in total per person

Those numbers are close to what workers and employers already pay. In 2025 the average employer plan for one person cost $9,325 a year, about $777 a month, and workers paid $1,440 of it, about $120 a month (KFF 2025 Employer Health Benefits Survey). Today that buys medical coverage only. HEALTH5 would aim to add dental, vision, hearing and prescriptions with no networks.

$5.3TWhat the U.S. spent on health in 2024, about $15,474 per person (CMS)
$3.395TProposed HEALTH5 funding at $832 a month for 340 million people
18%Share of the U.S. economy that went to health care in 2024 (Medical Economics)

Explore the funding model

What HEALTH5 would guarantee

Your doctor, not your network

Any participating licensed provider could treat you. Providers would accept the standard rate as payment in full, so there would be no surprise balance bills for covered care.

Coverage that stays put

Once enrolled, you would stay with your assigned insurer for five years. You couldn’t be dropped because you got sick or your claims got expensive.

Getting sick wouldn’t raise your price

A national risk pool would spread high-cost and low-cost members evenly across insurers, and that risk score would be kept separate from what you pay.

Insurers compete on service

Private insurers would stay in the system, but they would win members by being efficient and easy to deal with, not by avoiding sick people.

Honest about the numbers

Getting from $5.3 trillion (CMS 2024 data) to about $3.4 trillion is a 35% reduction. That doesn’t happen by cutting paperwork alone, and this proposal doesn’t pretend it does. Every dollar of savings has to be traced to a real spending category, backed by claims data, and tested against recessions, aging and pandemics.

We think the case for HEALTH5 gets stronger, not weaker, when the math is done in public, before lawmakers vote. So we built a tool that lets you try it yourself.

Try the reconciliation tool

Sources for this page

  1. CMS, About Administrative SimplificationCMS: standardized electronic transactions let the industry automate billing and payment, saving time and health care dollars.
  2. KFF, 2025 Employer Health Benefits SurveyAverage 2025 employer single premium of $9,325 a year, with workers paying $1,440 of it.
  3. CMS, National Health Expenditure Fact Sheet (2024 data)Total 2024 spending of $5.3 trillion and $15,474 per person; hospital, physician and drug spending; Medicare, Medicaid and private insurance totals; sponsor shares.
  4. Medical Economics, Health care spending reaches $5.3 trillion, or 18% of U.S. economy, in 2024 (Jan. 14, 2026)Health spending at 18% of GDP; hospitals $1.6 trillion, physician and clinical $1.1 trillion, drugs $467 billion.

Policy design details come from the UR2Big HEALTH5 Comprehensive Research and Policy Proposal (November 2026). See all sources.

Ask Congress to make five kinds of care one simple promise.

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