House Republicans introduced a new healthcare bill on Friday aimed at reducing costs and increasing insurance options for small businesses. This legislation sets the stage for an important vote next week as enhanced subsidies from the Affordable Care Act (ACA) are set to expire.
1. Legislation Overview
The bill, named the Lower Health Care Premiums for All Americans Act, was spearheaded by Rep. Mariannette Miller-Meeks. It serves as an alternative to Democratic efforts to prolong expiring ACA premium tax credits that assist 22 million Americans.
2. Association Health Plans
A major feature of the bill is the revival of association health plans, allowing employers to group together for insurance regardless of industry. This initiative was previously struck down but is now being reintroduced with specific governance and membership criteria.
3. Stop-Loss Insurance
The legislation clarifies that stop-loss insurance for self-insured plans is not considered as health insurance under federal law. This change can make it simpler for smaller firms to manage their own health costs while still protecting against large claims.
4. Health Reimbursement Arrangements (HRAs)
The bill extends the use of HRAs, enabling employers to fund individual health plan purchases instead of traditional group plans. This offers flexibility in funding based on different employee classes.
5. Pharmacy Benefit Manager (PBM) Transparency
New reporting mandates require PBMs to disclose financial information related to drug prices and payments to pharmacies. These requirements aim to improve transparency and accountability in prescription drug pricing.
6. Cost-Sharing Reductions (CSRs)
The legislation allocates funds to reinstate cost-sharing reductions starting in 2027, thereby lessening out-of-pocket costs for lower-income ACA enrollees.
7. Political Context
The bill does not include any measures to extend enhanced ACA subsidies, which face strong conservative opposition. GOP leaders argue their plan addresses healthcare costs directly, while Democrats criticize it as inadequate for improving healthcare accessibility.
As Congress approaches the end of its legislative session, the future of both this GOP package and the expiring ACA subsidies remains uncertain, with millions of Americans potentially facing increased premium costs.
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