GOP Plan To Save $35 Billion
A new report from the Congressional Budget Office (CBO) is giving House Republicans fresh momentum as health insurance costs once again become a top concern for voters heading into an election year.
According to the CBO, a Republican-backed healthcare bill scheduled for a House vote this week would lower Affordable Care Act (ACA) premiums by an estimated 11 percent while cutting federal deficits by more than $35 billion. GOP leaders say the findings confirm that market-driven reforms—not expanded government control—are the best way to make healthcare more affordable.
The analysis applies to the Lower Health Care Premiums for All Americans Act, introduced by House Speaker Mike Johnson (R-La.) and other Republican leaders. The CBO, along with the Joint Committee on Taxation, projects the savings would continue through 2035.
Lower Premiums, Smaller Government
While the CBO report estimates that roughly 100,000 fewer people would have health insurance over the next decade, Republicans argue the shift reflects consumers moving toward lower-cost, private coverage options rather than heavily subsidized Obamacare exchange plans.
Supporters say the bill directly targets the structural costs driving up healthcare prices, while expanding access to affordable insurance outside the federal exchanges.
Pharmacy Benefit Managers in the Spotlight
One major provision would strengthen transparency requirements for pharmacy benefit managers (PBMs)—powerful middlemen that control drug pricing and have faced bipartisan scrutiny for years.
The legislation would also permanently fund cost-sharing reduction payments, a move the CBO says accounts for much of the projected decline in ACA premiums.
Expanded Access to Affordable Group Plans
The bill further expands Association Health Plans, allowing self-employed workers, small businesses, and large organizations to pool together to purchase insurance. Supporters argue these plans often deliver better coverage at significantly lower prices than exchange-based policies.
While the CBO did not provide a detailed premium score for Association Health Plans, previous analyses cited by advocates show substantial savings. One earlier review found many of these plans offered strong benefits at prices below those available on Obamacare marketplaces.
Restoring Trump-Era Health Reforms
During President Donald Trump’s first term, federal rules allowed groups such as chambers of commerce to offer health coverage across county lines, giving small businesses more affordable choices. Those rules were later blocked after lawsuits from multiple states, forcing many plans out of the market.
The current legislation would codify those Trump-era reforms into law, providing long-term stability for employers and workers.
Additional provisions include protections for small and mid-sized businesses against catastrophic claims, as well as rules allowing employers to make defined contributions, enabling workers to select insurance plans that best fit their needs—a policy first introduced under President Trump.
Internal GOP Debate Remains
The CBO findings closely mirror an earlier analysis from the Paragon Health Institute, which projected roughly $30 billion in savings and premium reductions of about 12 percent, largely driven by funding cost-sharing payments.
Still, the bill may face internal debate within the Republican conference. The House is not expected to vote on extending enhanced ACA subsidies that are set to expire.
Rep. Mike Lawler (R-N.Y.) has warned that allowing those subsidies to lapse could raise premiums for some constituents, highlighting a potential fault line as Republicans emphasize cost savings and fiscal responsibility, while Democrats focus on expanding coverage through federal spending.
House GOP leaders have said they intend to move forward with their own healthcare reforms, arguing that long-term affordability—not temporary subsidies—should remain the priority.
