After more than eight years of the Affordable Care Act, known as Obamacare, health insurance costs continue to spiral out of control, particularly for millions of Americans trapped in the individual and small-group markets. Choice and competition in most of the states’ individual health insurance markets has virtually collapsed, leaving millions of Americans with either limited, or no, choice of health coverage. Patient access to physicians and medical specialists has declined, as health plan provider networks have progressively narrowed. The Health Care Choices Proposal offers Congress a path to reset the course of failed health care reform as a down payment on further needed reforms.