House GOP Unveils Healthcare Reform Plan with ACA Subsidy Debate

House Republicans have introduced a comprehensive 111-page healthcare reform plan titled the "Lower Health Care Premiums for All Americans Act," aiming for a vote next week. The legislation includes provisions to codify association health plans, which allow small businesses and self-employed individuals to collectively purchase healthcare coverage to leverage better bargaining power. Additionally, it aims to fund cost-sharing reductions starting in 2027 to reduce out-of-pocket expenses in the individual healthcare market, potentially lowering premiums by 12%. The plan also introduces new transparency requirements for pharmacy benefit managers (PBMs) to increase cost disclosure to employers, addressing bipartisan concerns about PBMs contributing to inflated healthcare costs. A significant point of contention within the GOP is the extension of enhanced Affordable Care Act (ACA) subsidies, initially expanded during the COVID-19 pandemic to make insurance more affordable. While moderate Republicans and Democrats push for the extension to prevent imminent premium hikes, many conservative Republicans oppose it unless it includes substantial reforms to what they view as a flawed system. Bipartisan efforts to vote on the subsidy extension face challenges, with Democratic leaders withholding full support. The ongoing debate highlights the tension between controlling healthcare costs and ensuring coverage affordability amid the 2026 midterm election cycle.