Mariannette Miller-Meeks (R-IA)
Lower Health Care Premiums for All Americans Act
A Republican bill with no cosponsors
Last activity — Received in the Senate.
Passed one chamber, waiting for the other to take it up
Passed one chamber, and the other has not yet sent it to a committee or put it on its calendar.
The other chamber will hand it to a committee, place it on its calendar, or leave it where it is. Nothing has been decided, and a bill can sit here indefinitely.
Its path through Congress
- Introduced
- Passed House 216–211
- Awaiting Senate
What this bill would do
The Lower Health Care Premiums for All Americans Act aims to increase access to affordable health insurance. It allows groups or associations of employers to maintain group health plans and introduces "custom health option and individual care expense arrangements" for employees. The bill also establishes strict reporting and oversight requirements for entities providing pharmacy benefit management services to increase transparency regarding drug costs. Additionally, it provides funding for cost sharing reduction payments starting in 2027.
Yes· 3 of 15
- Scored +7
Would business owners be better off under this?
Allows small business owners to form associations to get better rates on health insurance.
- Scored +7
Does this lower the price of prescription medicines?
Mandates transparency in PBM reporting, which is intended to lower costs by exposing drug pricing discrepancies.
- Scored +7
Does this make health care easier to get in general?
Increases options for workers and self-employed individuals to obtain affordable group health coverage.
The opposite· 3 of 5
- Scored -6
Does this make abortion easier to get?
Prohibits federal cost sharing reduction funds from being used for plans that cover abortion, except in specific narrow circumstances.
- Scored -4
Would women be better off under this?
Restricts funding for health plans that cover abortion, potentially limiting access to reproductive care.
- Scored -2
Does this reduce what the federal government owes?
The bill appropriates additional sums for cost sharing reduction payments starting in 2027.
What Congress actually voted on
2 recorded votes have been taken on this bill. One of them decided something; the rest moved it along.
- The House: the vote on whether to pass the bill This is the real decision in this chamber. Passing here sends the bill to the other chamber, which must pass it too before it can go to the President. Passed 216 yes · 211 no
12/17/2025 · Roll call 349 · recorded as “On Passage”
- The House: a last attempt to send the bill back to committee The minority party's final chance to change or stall a bill just before the vote on passage. It almost always fails; when it succeeds, the bill does not get its final vote that day. Motion to recommit rejected 210 yes · 218 no
12/17/2025 · Roll call 348 · recorded as “On Motion to Recommit”
Who it would affect, and how
Potential Positive Impacts for People
- Expanded Insurance Options: Workers can access group health plans through associations of employers, regardless of whether the employers are in the same industry or profession (Section 101(a)).
- Protections for Pre-existing Conditions: Group health plans established by associations of employers cannot deny coverage based on a pre-existing condition (Section 101(a)(3)(C)).
- Non-Discriminatory Enrollment: These association plans are prohibited from using health status-related factors to determine eligibility or to charge higher premiums for similarly situated individuals (Section 101(a)(3)(A)-(B)).
- Drug Cost Transparency: Pharmacy benefit management entities must provide reports to group health plans including drug lists, contracted compensation, and net prices after rebates, which helps in understanding drug spending (Section 201).
- Patient Access to Information: Participants or beneficiaries can request and receive summary documents and specific claims-level information regarding the difference between paid amounts and pharmacy compensation for their drug claims (Section 201(c)).
- Increased Funding: The bill appropriates funds necessary for cost sharing reduction payments for plan years beginning on or after January 1, 2027 (Section 202(h)(1)).
Potential Negative Impacts for People
- Limited Funding Eligibility: Federal funding for cost sharing reduction payments will not be provided to qualified health plans that cover abortion, unless it is to save the life of the mother or results from rape or incest (Section 202(h)(2)).
- Eligibility Verification Burdens: Self-employed individuals in association plans are subject to regular eligibility verification by a plan fiduciary, and may be denied coverage in following years if they are determined to no longer meet self-employment requirements (Section 101(a)(2)(C)).
Groups and Interests Ranking
Every group the model scored this bill for, from -10 to +10. Tap or hover a score for the reason it gave.
- Demographic And Interest Groups
- Would business owners be better off under this? — Allows small business owners to form associations to get better rates on health insurance. Would households on low incomes be better off under this? — Increases funding for cost sharing reductions which lowers out-of-pocket costs for low-income individuals. Would middle-income households be better off under this? — Lowers drug costs through transparency and expands affordable group insurance options. Would farmers be better off under this? — Provides a pathway for self-employed individuals (like farmers) to join group health plans. Would people in middle age be better off under this? — Provides more affordable health insurance options for working-age adults. Would people with disabilities be better off under this? — Protects against denial of coverage based on pre-existing conditions in association plans. Would people in rural areas be better off under this? — Helps rural self-employed individuals gain access to larger-scale insurance pools. Would women be better off under this? — Restricts funding for health plans that cover abortion, potentially limiting access to reproductive care.
- Healthcare
- Does this make health care easier to get in general? — Increases options for workers and self-employed individuals to obtain affordable group health coverage. Does this lower the price of prescription medicines? — Mandates transparency in PBM reporting, which is intended to lower costs by exposing drug pricing discrepancies. Does this lower what people pay for private health insurance? — Expands group purchasing options through association plans which can lead to lower premiums for members. Does this strengthen the Affordable Care Act? — Provides necessary funding for cost sharing reduction payments under the ACA. Does this make abortion easier to get? — Prohibits federal cost sharing reduction funds from being used for plans that cover abortion, except in specific narrow circumstances.
- Governance And Ideology
- Does this make what the government does easier for the public to see? — Increases transparency by mandating detailed reports on PBM drug costs and rebates. Does this give the federal government more power? — Grants the Secretary of HHS and Labor expanded oversight and enforcement authority over PBMs.
- Economy And Finance
- Does this give people more protection from unfair business practices? — Improves transparency and oversight of Pharmacy Benefit Managers, giving consumers more data on drug costs. Does this make it easier to run a small business? — Allows small employers and self-employed individuals to access group health plans via associations, increasing their bargaining power. Does this make the government pay for what it commits to? — The bill creates new spending obligations without specified offsets. Does this reduce what the federal government spends? — The bill increases spending through the appropriation of funds for cost sharing reduction payments. Does this reduce what the federal government owes? — The bill appropriates additional sums for cost sharing reduction payments starting in 2027.
- 12/18/2025
- Received in the Senate.
- 12/17/2025
- Motion to reconsider laid on the table Agreed to without objection.
- Passed/agreed to in House: On passage Passed by the Yeas and Nays: 216 - 211 (Roll no. 349).
- On passage Passed by the Yeas and Nays: 216 - 211 (Roll no. 349). (text: CR H5956-5966)
- On motion to recommit Failed by the Yeas and Nays: 210 - 218 (Roll no. 348).
- Considered as unfinished business. (consideration: CR H6006-6008)
- POSTPONED PROCEEDINGS - At the conclusion of debate on H.R. 6703, the Chair put the question on motion to recommit and by voice vote, announced the noes had prevailed. Ms. Underwood demanded the yeas and nays and the Chair postponed further proceedings until a time to be announced.
- The previous question on the motion to recommit was ordered pursuant to clause 2(b) of rule XIX.
- Ms. Underwood moved to recommit to the Committee on Energy and Commerce. (text: CR H5977)
- The previous question was ordered pursuant to the rule.
- DEBATE - The House proceeded with one hour of debate on H.R. 6703.
- Rule provides for consideration of H.R. 6703, H.R. 498 and H.R. 3492. The resolution provides for consideration of H.R. 6703 and H.R. 498 under a closed rule and H.R. 3492 under a structured rule with one hour of general debate and one motion to recommit on each bill.
- Considered under the provisions of rule H. Res. 953. (consideration: CR H5956-5977)
- Rules Committee Resolution H. Res. 953 Reported to House. Rule provides for consideration of H.R. 6703, H.R. 498 and H.R. 3492. The resolution provides for consideration of H.R. 6703 and H.R. 498 under a closed rule and H.R. 3492 under a structured rule with one hour of general debate and one motion to recommit on each bill.
- 12/15/2025
- Referred to the Committee on Energy and Commerce, and in addition to the Committees on Education and Workforce, and Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
- Introduced in House
2 bills Congress.gov lists as related to this one — companions in the other chamber, earlier versions, and bills this one absorbed or was folded into.
- 119-HR-2450: Prescription Drug Transparency and Affordability Act
- 119-HRES-953: Providing for consideration of the bill (H.R. 6703) to ensure access to affordable health insurance; providing for consideration of the bill (H.R. 498) to amend title XIX of the Social Security Act to prohibit Federal Medicaid funding for gender transition procedures for minors; providing for consideration of the bill (H.R. 3492) to amend section 116 of title 18, United States Code, with respect to genital and bodily mutilation and chemical castration of minors; and relating to consideration of the bill (H.R. 4776) to amend the National Environmental Policy Act of 1969 to clarify ambiguous provisions and facilitate a more efficient, effective, and timely environmental review process.