All Roll Calls
Yes: 426 • No: 429
HR6703119th CongressWALLET
Lower Health Care Premiums for All Americans Act
Sponsored By: Representative Miller-Meeks, Mariannette [R-IA-1]
Passed House
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.
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- 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.
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Bill Overview
Analyzed Economic Effects
4 provisions identified: 2 benefits, 0 costs, 2 mixed.
Federal payments for ACA cost-sharing reductions
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 for CSR payments for any qualified health plan that provides abortion coverage except when coverage is limited to saving the mother's life or for pregnancies resulting from rape or incest.
More PBM price and payment transparency
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 utilization. For drugs with over $10,000 in gross spending, reports must include similar drugs and a formulary rationale. Plans must notify participants each year and let them request claims-level details. The Secretary must issue a standard report format and final rules within 18 months.
New CHOICE health reimbursement accounts
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 offer CHOICE to every worker in the same class on the same terms and generally may not offer another group health plan to that class. The plan must verify qualifying coverage, substantiate claims, follow nondiscrimination rules, and set maximum dollar amounts per participant. Any participant's maximum could not exceed 300% of the lowest maximum after allowed age or dependent adjustments.
New rules for association employer health plans
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 employees and to all employees of member employers. Self-employed people could join an aggregated group only if it has at least 20 members, and plans must regularly verify self‑employment. The bill also clarifies stop‑loss treatment and adds ERISA preemption where State law would block such stop‑loss arrangements.
Sponsors & CoSponsors
Sponsor
Miller-Meeks, Mariannette [R-IA-1]
IA • R
Cosponsors
There are no cosponsors for this bill.
Roll Call Votes
house vote • 12/17/2025
On Passage
Yes: 216 • No: 211
house vote • 12/17/2025
On Motion to Recommit
Yes: 210 • No: 218