Republicans Unveil Obamacare Alternative As Subsidy Deadline Looms
Joe Cunningham
House Republicans released legislation Friday aimed at lowering healthcare costs through expanded insurance options for small businesses and unprecedented transparency requirements for pharmacy benefit managers, setting up a crucial vote next week as enhanced Obamacare subsidies expire at year’s end.
The Lower Health Care Premiums for All Americans Act, introduced by Rep. Mariannette Miller-Meeks (R-Iowa-01), is the GOP's alternative to Democratic proposals as Democrats push to extend expiring ACA premium tax credits that help 22 million Americans purchase insurance.
Speaker Mike Johnson announced the measure would receive a floor vote next week, though GOP leadership indicated moderate Republicans seeking subsidy extensions may get an amendment vote designed to provide political cover without realistic chances of passage.
Association Health Plans ReturnThe bill’s centerpiece codifies association health plans, reviving a Trump-era initiative that federal courts struck down in 2019. The Biden administration formally rescinded the association health plan regulations back in 2024, dismissing pending appeals.
Under the legislation, groups or associations of employers could band together to offer health insurance regardless of industry, provided they:
Existed for at least two years for purposes other than providing insurance
Establish formal governance with employer-controlled boards
Cover at least 51 employees total
Offer coverage to all employees of member employers
Self-employed individuals could join as both employers and employees if they work at least 10 hours weekly or 40 hours monthly in their business, with at least 20 self-employed members needed to form a group.
The bill includes protections requiring plans to follow ACA nondiscrimination rules, prohibiting denial of coverage for pre-existing conditions and health status-based premium variations. Plans could establish base premiums using modified community rating across all participants, then adjust individual employer contributions based on specific risk profiles.
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https://redstate.com/joesquire/2025/12/13/republicans-unveil-obamacare-alternative-as-subsidy-deadline-looms-n2197089
