For years, Democrats have wielded the tired accusation that Republicans lack a healthcare alternative to the Affordable Care Act, commonly referred to as Obamacare.
On Friday, House Republicans called that bluff, unveiling the Lower Health Care Premiums for All Americans Act, a legislative package aimed at dismantling the cost drivers embedded in the Affordable Care Act while expanding choice and transparency. The bill heads to the House floor next week, and predictably, Democrats are already scrambling to kill it.
“Nearly 15 years ago, the Democrats’ Unaffordable Care Act broke the American health care system. Since its inception, premium costs have skyrocketed, networks have shrunk, and the system has become bloated, inefficient, and riddled with waste, fraud, and abuse. While Democrats demand that taxpayers write bigger checks to insurance companies to hide the cost of their failed law, House Republicans are tackling the real drivers of health care costs to provide affordable care, increase access and choice, and restore integrity to our nation’s health care system for all Americans,” House Speaker Mike Johnson said in a statement.
“Earlier this year, Democrats had a chance to help make life more affordable by supporting the Working Families Tax Cuts legislation,” Johnson continued. “Instead, they voted to raise taxes, protect waste and fraud, and continue providing free health care to illegal immigrants. Democrats’ ‘affordability’ charade has gone on long enough.”
Johnson said the new Republican proposal offers a responsible path forward on health care, cutting premium costs while expanding access to quality health care options for Americans nationwide. “The Lower Health Care Premiums for All Americans Act will actually deliver affordable health care – and we look forward to advancing it through the House.”
A key aspect of the legislation is a push for transparency for pharmacy benefit managers. PBMs, the middlemen who negotiate drug prices and rebates, have long operated without any transparency at all at the expense of employers and patients. The proposed legislation would force PBMs to disclose detailed data on prescription drug spending, rebates, spread pricing, and formulary decisions. Employers and workers would finally see what they’re paying for – and what they’re not getting in return.
According to Johnson, the bill also appropriates funding for cost-sharing reduction payments beginning in 2027. These payments, meant to lower premiums and stabilize the individual market, would be directed toward low-income enrollees. The measure aims to ensure taxpayer dollars are spent responsibly rather than being dumped into a system that rewards insurers for inflated costs, as the current system does.
Beyond transparency, the legislation expands health coverage options for American workers through Association Health Plans. These plans allow employers, including the self-employed, to pool resources across industries to purchase high-quality, more affordable coverage.
Republicans have long advocated for the idea that by banding together, small businesses and independent workers gain the negotiating power currently monopolized by large corporations and government-run exchanges.
The bill also clarifies that stop-loss insurance – coverage that protects employers from catastrophic claims—is not “health insurance coverage” under federal law. This distinction allows small and mid-sized businesses to tailor their employee benefits without triggering the burdensome regulations of Obamacare.
Another provision codifies and strengthens the 2019 rules that allow employers to offer defined contributions for employees to purchase their own coverage. These arrangements, rebranded as CHOICE arrangements, let employees pay premiums on a pre-tax basis while selecting plans that fit their needs rather than accepting whatever their employer chooses.
The concept is simple: give workers control over their healthcare dollars and let them shop for the coverage that works best for them.
Naturally, Democrats hate it.
House Minority Leader Hakeem Jeffries wasted no time trashing the proposal, dismissing it as “likely to be a disaster” before he even knew what was in it. Speaking to MS NOW on Friday, Jeffries claimed the package would diminish rather than enhance American healthcare, though he offered no specifics to support his assertion. His vague prophecy of doom reflects the Democrats’ broader strategy: attack anything that threatens Obamacare’s legacy, regardless of the facts.
Jeffries suggests that a vote on the GOP health care bill + amendment vote on Fitzpatrick bill won’t be suitable for Democrats.
“Their health care package, as I understand it, is likely to be a disaster and actually not enhance the health care of the American people. It will… pic.twitter.com/Sr6JbZE9zT
— Mychael Schnell (@mychaelschnell) December 12, 2025
But that doesn’t change the fact that the Affordable Care Act has been a disaster. A recent Forbes analysis found that since it was passed in 2010, premiums have nearly tripled and deductibles have more than doubled. The cost of coverage for a family of four has surged by more than $10,000. Worse, the coverage itself has deteriorated. Americans are paying more for less, a reality that Democrats refuse to acknowledge.
The Forbes analysis also shows that Obamacare deductibles run far higher than those in employer-sponsored plans. The law was marketed to the public as a way to create affordable, accessible care. Instead, it became a case study in government overreach that enriched insurers and bureaucrats while sticking middle-class families with soaring costs. That was entirely by design.
Republicans are betting that Americans have had enough. The Lower Health Care Premiums for All Americans Act offers a clear alternative: transparency over opacity, choice over mandates, and market competition over government control. Whether it passes remains to be seen, but the message is unmistakable. Democrats built Obamacare. Republicans are offering a way out.
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