A Republican health care bill introduced in the House Friday evening would not extend expiring enhanced ACA subsidies — a measure being demanded by Democrats — but instead allow employers to work with others across industries to purchase group health plans together and mandate greater transparency from pharmacy benefit managers, the so-called “drug middlemen.”
GOP leaders, in a concession to moderates in its party, will allow a floor vote to extend the enhanced subsidies, Politico reported.
The new legislation, dubbed The Lower Health Care Premium for All Americans Act and introduced by Rep. Mariannette Miller-Meeks (R-Iowa), would provide funding for cost sharing reduction staring in 2027, “lowering premiums and stabilizing the individual market while ensuring taxpayer dollars are used responsibly,” a news release from Speaker Mike Johnson (R-La.) stated.
On the PBM front, the bill would require them to provide employers with data on prescription drug spending, rebates, spread pricing, and formulary choices.
Accessibility to Association Health Plans would also increase. Currently, these plans are only available to employers in the same trade, industry, or profession, with no options for the self-employed. The legislation would change this by allowing employers irrespective of industry or profession to join together, and also allow the self-employed to take part.
In addition, it would formalize a concept known as Custom Health Option and Individual Care Expense (CHOICE) arrangement permiting employers to give money to employees to purchase their own coverage and pay those premiums pre-tax.
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