WASHINGTON – House Republican leaders on Friday released a draft health care bill package aimed at lowering costs for 2026, setting up a potential floor vote later this week. The House Rules Committee is scheduled to review the 111-page bill on Tuesday afternoon to determine if it will move forward for consideration on the House floor.
The legislation combines several measures designed to make health care more affordable. Key provisions include expanding access to association health plans, which allow employers across industries to band together to purchase coverage at lower costs, requiring increased transparency from pharmacy benefit managers, and reinstating cost-sharing reduction payments that were canceled in 2017. The bill does not extend enhanced Affordable Care Act subsidies, which are set to expire on December 31, a change expected to raise premiums for roughly one-third of ACA marketplace enrollees. Speaker Mike Johnson, R-La., praised the package, saying it targets “the real drivers of health care costs” while improving access, choice, and system integrity.
Sponsored by Rep. Mariannette Miller-Meeks, R-Iowa, who faces a competitive reelection race, the bill also seeks to reverse the 2017 cancellation of cost-sharing reduction payments to insurers, lowering out-of-pocket expenses like deductibles and copays for enrollees starting in 2027. It would impose new transparency rules on pharmacy benefit managers, requiring them to disclose detailed prescription drug spending, rebates, formulary decisions, and pricing practices. The legislation clarifies that stop-loss insurance policies should not be considered health insurance, a move intended to protect small businesses from catastrophic claims.
While expanding association health plans has been a long-standing Republican goal, these plans typically do not include all ACA-mandated essential health benefits. Proposals to fund health savings accounts for ACA enrollees were not included after failing a procedural Senate vote. The Rules Committee is set to consider this bill on Tuesday alongside two separate measures aimed at restricting gender-affirming care for minors.