# 119-hr-6703: Lower Health Care Premiums for All Americans Act

119-hr-6703, Lower Health Care Premiums for All Americans Act, is a 119th Congress bill sponsored by Rep. Miller-Meeks, Mariannette [R-IA-1] (R-IA); status passed_house; PRIA reads it as touching household money (as of 2026-04-21).

- Canonical: https://policyrisk.com/legislation/119-hr-6703
- As of: 2026-04-21
- Plain-text twin of the page above; the HTML and this file carry the same facts.

## Facts
- Bill: 119-hr-6703
- Congress: 119
- Title: Lower Health Care Premiums for All Americans Act
- Status: passed_house
- Introduced: 2025-12-15
- Sponsor: Rep. Miller-Meeks, Mariannette [R-IA-1] (R-IA)
- Cosponsors: 0
- Policy area: Health
- Touches household money: yes
- Last recorded action: 2026-04-21

## Summary

**Creates a new set of employer-run health plan options under ERISA.** It would let groups and associations run Association Health Plans and create employer-funded CHOICE reimbursement arrangements while imposing broad pharmacy benefit manager reporting rules to boost drug-price transparency. - Employers and small businesses: Would let associations of employers from different industries offer a single ERISA group plan if they meet governance and eligibility rules, have existed at least 2 years, and make coverage available to at least 51 employees. Aggregated groups of self-employed people can count as an employer member if they include at least 20 individuals. - Workers and participants: CHOICE arrangements would be funded only by employers and pay fixed maximums for care when employees have minimum individual coverage or Medicare. CHOICE requires written notices before the plan year and adds W-2 reporting for taxable years after 2025. - PBMs, plans, and regulators: Would require pharmacy benefit managers to deliver semiannual (or quarterly on request) machine-readable reports with drug-level and plan-level data. Reports must include rebates, per-drug spending, affiliated-pharmacy pricing, and special disclosures for drugs with gross spending over $10,000. Large-employer plans (about 100 or more employees) may opt in for fuller reporting.

## Votes

| Date | Chamber | Question | Result | Yea | Nay |
| --- | --- | --- | --- | --- | --- |
| 2025-12-17T00:00:00.000Z | house | On Motion to Recommit | Failed | 210 | 218 |
| 2025-12-17T00:00:00.000Z | house | On Passage | Passed | 216 | 211 |

## Provisions PRIA read

- Federal payments for ACA cost-sharing reductions: benefit, medium. If enacted, the bill would appropriate 'such sums as may be necessary' to make ACA cost‑sharing reduction (CSR) payments for plan years beginning on or after January 1, 2027. That would lower out-of-pocket costs for marketplace enrollees who qualify for CSRs. Appropriated amounts could not be used…
- More PBM price and payment transparency: benefit, medium. If enacted, PBMs would have to provide group health plans with detailed, plain-language reports at least every six months, starting for plan years that begin 30 months after enactment. Reports must show per-drug prices, rebates, PBM and pharmacy payments, participant out-of-pocket spending, and uti…
- New CHOICE health reimbursement accounts: mixed, medium. If enacted, the bill would create a new employer-funded health reimbursement called a CHOICE arrangement. Employers would fund CHOICE accounts and only pay or reimburse medical care when you have individual-market insurance (not just excepted benefits) or Medicare Part A, B, or C. Employers must of…
- New rules for association employer health plans: mixed, medium. If enacted, the bill would let groups of employers maintain ERISA-covered association health plans even if members are in different industries. Associations must have been formed in good faith for other purposes, exist at least two years, have a governing board, and offer coverage to at least 51 em…

## Related bills

- 119-hr-9237: Take Care of America’s Veterans Act
- 119-hr-4669: FEMA Act of 2025
- 119-hr-2725: Affordable Housing Credit Improvement Act of 2025
- 119-hr-4317: PBM Reform Act of 2025
- 119-hr-4895: Afghan Adjustment Act
- 119-hr-1656: PLUS for Veterans Act of 2025

## Sources
- [119-hr-6703 on Congress.gov](https://www.congress.gov/bill/119th-congress/house-bill/6703)

## Related
- [119-hr-9237: Take Care of America’s Veterans Act](https://policyrisk.com/legislation/119-hr-9237)
- [119-hr-4669: FEMA Act of 2025](https://policyrisk.com/legislation/119-hr-4669)
- [119-hr-2725: Affordable Housing Credit Improvement Act of 2025](https://policyrisk.com/legislation/119-hr-2725)
- [119-hr-4317: PBM Reform Act of 2025](https://policyrisk.com/legislation/119-hr-4317)
- [119-hr-4895: Afghan Adjustment Act](https://policyrisk.com/legislation/119-hr-4895)
- [119-hr-1656: PLUS for Veterans Act of 2025](https://policyrisk.com/legislation/119-hr-1656)
- [All bills in Congress](https://policyrisk.com/legislation)

Source: PRIA, https://policyrisk.com/legislation/119-hr-6703 (as of 2026-04-21).