The Affordable Care Act requires that all health plans provide ten essential benefits. All Americans would be required to contribute to a privately-run, interest bearing, pre-tax heath savings account to cover the cost of these ten essential benefits which would be funded through automated payroll deductions. The plan would have tiers of service that is directly linked to the level of service chosen by the plan contributor. Plan participants could choose from a private provider or public provider for essential services. Private insurance plans would be available for services beyond the ten essentials.