H.R. 6703: Lower Health Care Premiums for All Americans Act
Bill · 119th Congress (2025–2026). Passed House, 17 Dec 2025. Introduced 15 Dec 2025.
Official title: To ensure access to affordable health insurance.
Vote results
- House, 17 Dec 2025: Passed, 216 Yea, 211 Nay, 0 Present, 6 Not voting. The House’s roll call
- Senate: not yet considered.
- President: Not before the President yet: both chambers must pass it first.
How each member voted
Senate
Not yet considered.
House
Yea (216): Harold Rogers (R-KY-5); Christopher H. Smith (R-NJ-4); Ken Calvert (R-CA-41); Frank D. Lucas (R-OK-3); Robert B. Aderholt (R-AL-4); Michael K. Simpson (R-ID-2); Pete Sessions (R-TX-17); Sam Graves (R-MO-6); Joe Wilson (R-SC-2); John R. Carter (R-TX-31); Tom Cole (R-OK-4); Mario Diaz-Balart (R-FL-26); Mike Rogers (R-AL-3); Michael R. Turner (R-OH-10); Darrell Issa (R-CA-48); Virginia Foxx (R-NC-5); Michael T. McCaul (R-TX-10); Gus M. Bilirakis (R-FL-12); Vern Buchanan (R-FL-16); Jim Jordan (R-OH-4); Adrian Smith (R-NE-3); Robert E. Latta (R-OH-5); Robert J. Wittman (R-VA-1); Steve Scalise (R-LA-1); Tim Walberg (R-MI-5); Brett Guthrie (R-KY-2); Tom McClintock (R-CA-5); Glenn Thompson (R-PA-15); Eric A. "Rick" Crawford (R-AR-1); Scott DesJarlais (R-TN-4); Charles J. "Chuck" Fleischmann (R-TN-3); Paul A. Gosar (R-AZ-9); H. Morgan Griffith (R-VA-9); Andy Harris (R-MD-1); Bill Huizenga (R-MI-4); Mike Kelly (R-PA-16); David Schweikert (R-AZ-1); Austin Scott (R-GA-8); Daniel Webster (R-FL-11); Mark E. Amodei (R-NV-2); Andy Barr (R-KY-6); Richard Hudson (R-NC-9); David P. Joyce (R-OH-14); Scott Perry (R-PA-10); Ann Wagner (R-MO-2); Randy K. Weber, Sr. (R-TX-14); Roger Williams (R-TX-25); Jason Smith (R-MO-8); Rick W. Allen (R-GA-12); Brian Babin (R-TX-36); Mike Bost (R-IL-12); Earl L. "Buddy" Carter (R-GA-1); Tom Emmer (R-MN-6); Glenn Grothman (R-WI-6); J. French Hill (R-AR-2); Barry Loudermilk (R-GA-11); John R. Moolenaar (R-MI-2); Dan Newhouse (R-WA-4); David Rouzer (R-NC-7); Elise M. Stefanik (R-NY-21); Bruce Westerman (R-AR-4); David G. Valadao (R-CA-22); Trent Kelly (R-MS-1); Darin LaHood (R-IL-16); Warren Davidson (R-OH-8); James Comer (R-KY-1); Jodey C. Arrington (R-TX-19); Don Bacon (R-NE-2); Jack Bergman (R-MI-1); Andy Biggs (R-AZ-5); Neal P. Dunn (R-FL-2); Brian K. Fitzpatrick (R-PA-1); Clay Higgins (R-LA-3); Mike Johnson (R-LA-4); David Kustoff (R-TN-8); Brian J. Mast (R-FL-21); John H. Rutherford (R-FL-5); Lloyd Smucker (R-PA-11); Ron Estes (R-KS-4); Ralph Norman (R-SC-5); Michael Cloud (R-TX-27); Troy Balderson (R-OH-12); Kevin Hern (R-OK-1); Marlin A. Stutzman (R-IN-3); James R. Baird (R-IN-4); Tim Burchett (R-TN-2); Ben Cline (R-VA-6); Dan Crenshaw (R-TX-2); Russ Fulcher (R-ID-1); Lance Gooden (R-TX-5); Michael Guest (R-MS-3); Dusty Johnson (R-SD-AL); John Joyce (R-PA-13); Daniel Meuser (R-PA-9); Carol D. Miller (R-WV-1); Guy Reschenthaler (R-PA-14); John W. Rose (R-TN-6); Chip Roy (R-TX-21); Pete Stauber (R-MN-8); Bryan Steil (R-WI-1); W. Gregory Steube (R-FL-17); William R. Timmons IV (R-SC-4); Jefferson Van Drew (R-NJ-2); Claudia Tenney (R-NY-24); Thomas P. Tiffany (R-WI-7); Ryan K. Zinke (R-MT-1); Cliff Bentz (R-OR-2); Stephanie I. Bice (R-OK-5); Lauren Boebert (R-CO-4); Kat Cammack (R-FL-3); Andrew S. Clyde (R-GA-9); Byron Donalds (R-FL-19); Pat Fallon (R-TX-4); Randy Feenstra (R-IA-4); Michelle Fischbach (R-MN-7); Scott Fitzgerald (R-WI-5); Scott Franklin (R-FL-18); Andrew R. Garbarino (R-NY-2); Carlos A. Gimenez (R-FL-28); Diana Harshbarger (R-TN-1); Ashley Hinson (R-IA-2); Ronny Jackson (R-TX-13); Young Kim (R-CA-40); Nancy Mace (R-SC-1); Nicole Malliotakis (R-NY-11); Tracey Mann (R-KS-1); Lisa C. McClain (R-MI-9); Mary E. Miller (R-IL-15); Mariannette Miller-Meeks (R-IA-1); Barry Moore (R-AL-1); Blake D. Moore (R-UT-1); Troy E. Nehls (R-TX-22); Jay Obernolte (R-CA-23); Burgess Owens (R-UT-4); August Pfluger (R-TX-11); Maria Elvira Salazar (R-FL-27); Victoria Spartz (R-IN-5); Beth Van Duyne (R-TX-24); Julia Letlow (R-LA-5); Jake Ellzey (R-TX-6); Mike Carey (R-OH-15); Mike Flood (R-NE-1); Brad Finstad (R-MN-1); Rudy Yakym III (R-IN-2); Mark Alford (R-MO-4); Aaron Bean (R-FL-4); Josh Brecheen (R-OK-2); Eric Burlison (R-MO-7); Juan Ciscomani (R-AZ-6); Mike Collins (R-GA-10); Elijah Crane (R-AZ-2); Monica De La Cruz (R-TX-15); Chuck Edwards (R-NC-11); Mike Ezell (R-MS-4); Russell Fry (R-SC-7); Harriet M. Hageman (R-WY-AL); Erin Houchin (R-IN-9); Wesley Hunt (R-TX-38); John James (R-MI-10); Thomas H. Kean, Jr. (R-NJ-7); Jennifer A. Kiggans (R-VA-2); Kevin Kiley (I-CA-3); Nick LaLota (R-NY-1); Nicholas A. Langworthy (R-NY-23); Michael Lawler (R-NY-17); Laurel M. Lee (R-FL-15); Anna Paulina Luna (R-FL-13); Morgan Luttrell (R-TX-8); Richard McCormick (R-GA-7); Max L. Miller (R-OH-7); Cory Mills (R-FL-7); Nathaniel Moran (R-TX-1); Zachary Nunn (R-IA-3); Andrew Ogles (R-TN-5); Keith Self (R-TX-3); Dale W. Strong (R-AL-5); Derrick Van Orden (R-WI-3); Celeste Maloy (R-UT-2); Vince Fong (R-CA-20); Michael A. Rulli (R-OH-6); Tony Wied (R-WI-8); Tom Barrett (R-MI-7); Michael Baumgartner (R-WA-5); Nicholas J. Begich III (R-AK-AL); Sheri Biggs (R-SC-3); Robert P. Bresnahan, Jr. (R-PA-8); Jeff Crank (R-CO-5); Troy Downing (R-MT-2); Gabe Evans (R-CO-8); Julie Fedorchak (R-ND-AL); Brandon Gill (R-TX-26); Craig A. Goldman (R-TX-12); Abraham J. Hamadeh (R-AZ-8); Mike Haridopolos (R-FL-8); Pat Harrigan (R-NC-10); Mark Harris (R-NC-8); Jeff Hurd (R-CO-3); Brian Jack (R-GA-3); Mike Kennedy (R-UT-3); Brad Knott (R-NC-13); Ryan Mackenzie (R-PA-7); Addison P. McDowell (R-NC-6); John J. McGuire III (R-VA-5); Mark B. Messmer (R-IN-8); Riley M. Moore (R-WV-2); Tim Moore (R-NC-14); Robert F. Onder, Jr. (R-MO-3); Derek Schmidt (R-KS-2); Jefferson Shreve (R-IN-6); David J. Taylor (R-OH-2); Randy Fine (R-FL-6); Jimmy Patronis (R-FL-1); Matt Van Epps (R-TN-7); Doug LaMalfa (R-CA-1); Tony Gonzales (R-TX-23); Marjorie Taylor Greene (R-GA-14).
Nay (211): Steny H. Hoyer (D-MD-5); Marcy Kaptur (D-OH-9); Nancy Pelosi (D-CA-11); Frank Pallone, Jr. (D-NJ-6); Richard E. Neal (D-MA-1); Rosa L. DeLauro (D-CT-3); Maxine Waters (D-CA-43); Jerrold Nadler (D-NY-12); Sanford D. Bishop, Jr. (D-GA-2); James E. Clyburn (D-SC-6); Robert C. "Bobby" Scott (D-VA-3); Nydia M. Velázquez (D-NY-7); Bennie G. Thompson (D-MS-2); Lloyd Doggett (D-TX-37); Zoe Lofgren (D-CA-18); Danny K. Davis (D-IL-7); Diana DeGette (D-CO-1); James P. McGovern (D-MA-2); Brad Sherman (D-CA-32); Adam Smith (D-WA-9); Gregory W. Meeks (D-NY-5); John B. Larson (D-CT-1); Janice D. Schakowsky (D-IL-9); Mike Thompson (D-CA-4); Rick Larsen (D-WA-2); Betty McCollum (D-MN-4); Stephen F. Lynch (D-MA-8); Linda T. Sánchez (D-CA-38); Emanuel Cleaver (D-MO-5); Jim Costa (D-CA-21); Henry Cuellar (D-TX-28); Al Green (D-TX-9); Gwen Moore (D-WI-4); Debbie Wasserman Schultz (D-FL-25); Doris O. Matsui (D-CA-7); Kathy Castor (D-FL-14); Yvette D. Clarke (D-NY-9); Steve Cohen (D-TN-9); Henry C. "Hank" Johnson, Jr. (D-GA-4); André Carson (D-IN-7); James A. Himes (D-CT-4); Chellie Pingree (D-ME-1); Paul Tonko (D-NY-20); Mike Quigley (D-IL-5); Judy Chu (D-CA-28); John Garamendi (D-CA-8); Bill Foster (D-IL-11); William R. Keating (D-MA-9); Terri A. Sewell (D-AL-7); Frederica S. Wilson (D-FL-24); Dina Titus (D-NV-1); Kweisi Mfume (D-MD-7); Suzanne Bonamici (D-OR-1); Suzan K. DelBene (D-WA-1); Thomas Massie (R-KY-4); Joyce Beatty (D-OH-3); Ami Bera (D-CA-6); Julia Brownley (D-CA-26); Joaquin Castro (D-TX-20); Lois Frankel (D-FL-22); Jared Huffman (D-CA-2); Hakeem S. Jeffries (D-NY-8); Grace Meng (D-NY-6); Scott H. Peters (D-CA-50); Mark Pocan (D-WI-2); Raul Ruiz (D-CA-25); Mark Takano (D-CA-39); Juan Vargas (D-CA-52); Marc A. Veasey (D-TX-33); Robin L. Kelly (D-IL-2); Katherine M. Clark (D-MA-5); Alma S. Adams (D-NC-12); Donald Norcross (D-NJ-1); Pete Aguilar (D-CA-33); Donald S. Beyer, Jr. (D-VA-8); Brendan F. Boyle (D-PA-2); Ed Case (D-HI-1); Mark DeSaulnier (D-CA-10); Debbie Dingell (D-MI-6); Ted Lieu (D-CA-36); Seth Moulton (D-MA-6); Norma J. Torres (D-CA-35); Bonnie Watson Coleman (D-NJ-12); Bradley Scott Schneider (D-IL-10); Dwight Evans (D-PA-3); Nanette Diaz Barragán (D-CA-44); Salud O. Carbajal (D-CA-24); J. Luis Correa (D-CA-46); Adriano Espaillat (D-NY-13); Vicente Gonzalez (D-TX-34); Josh Gottheimer (D-NJ-5); Steven Horsford (D-NV-4); Pramila Jayapal (D-WA-7); Ro Khanna (D-CA-17); Raja Krishnamoorthi (D-IL-8); Jimmy Panetta (D-CA-19); Jamie Raskin (D-MD-8); Darren Soto (D-FL-9); Jimmy Gomez (D-CA-34); Thomas R. Suozzi (D-NY-3); Joseph D. Morelle (D-NY-25); Mary Gay Scanlon (D-PA-5); Sean Casten (D-IL-6); Angie Craig (D-MN-2); Jason Crow (D-CO-6); Sharice Davids (D-KS-3); Madeleine Dean (D-PA-4); Veronica Escobar (D-TX-16); Lizzie Fletcher (D-TX-7); Sylvia R. Garcia (D-TX-29); Jesús G. "Chuy" García (D-IL-4); Jared F. Golden (D-ME-2); Josh Harder (D-CA-9); Jahana Hayes (D-CT-5); Chrissy Houlahan (D-PA-6); Susie Lee (D-NV-3); Mike Levin (D-CA-49); Joe Neguse (D-CO-2); Alexandria Ocasio-Cortez (D-NY-14); Ilhan Omar (D-MN-5); Chris Pappas (D-NH-1); Ayanna Pressley (D-MA-7); Kim Schrier (D-WA-8); Greg Stanton (D-AZ-4); Haley M. Stevens (D-MI-11); Rashida Tlaib (D-MI-12); Lori Trahan (D-MA-3); Lauren Underwood (D-IL-14); Jake Auchincloss (D-MA-4); Cleo Fields (D-LA-6); Sara Jacobs (D-CA-51); Teresa Leger Fernandez (D-NM-3); Frank J. Mrvan (D-IN-1); Deborah K. Ross (D-NC-2); Marilyn Strickland (D-WA-10); Ritchie Torres (D-NY-15); Nikema Williams (D-GA-5); Troy A. Carter (D-LA-2); Melanie A. Stansbury (D-NM-1); Shontel M. Brown (D-OH-11); Patrick Ryan (D-NY-18); Becca Balint (D-VT-AL); Nikki Budzinski (D-IL-13); Greg Casar (D-TX-35); Gilbert Ray Cisneros, Jr. (D-CA-31); Jasmine Crockett (D-TX-30); Donald G. Davis (D-NC-1); Christopher R. Deluzio (D-PA-17); Valerie P. Foushee (D-NC-4); Maxwell Frost (D-FL-10); Robert Garcia (D-CA-42); Marie Gluesenkamp Perez (D-WA-3); Daniel S. Goldman (D-NY-10); Val T. Hoyle (D-OR-4); Glenn Ivey (D-MD-4); Jonathan L. Jackson (D-IL-1); Sydney Kamlager-Dove (D-CA-37); Greg Landsman (D-OH-1); Summer L. Lee (D-PA-12); Seth Magaziner (D-RI-2); Morgan McGarvey (D-KY-3); Robert Menendez (D-NJ-8); Jared Moskowitz (D-FL-23); Kevin Mullin (D-CA-15); Brittany Pettersen (D-CO-7); Delia C. Ramirez (D-IL-3); Andrea Salinas (D-OR-6); Hillary J. Scholten (D-MI-3); Eric Sorensen (D-IL-17); Emilia Strong Sykes (D-OH-13); Shri Thanedar (D-MI-13); Jill N. Tokuda (D-HI-2); Gabe Vasquez (D-NM-2); Jennifer L. McClellan (D-VA-4); Gabe Amo (D-RI-1); Timothy M. Kennedy (D-NY-26); LaMonica McIver (D-NJ-10); Yassamin Ansari (D-AZ-3); Wesley Bell (D-MO-1); Janelle S. Bynum (D-OR-5); Herbert C. Conaway, Jr. (D-NJ-3); Maxine Dexter (D-OR-3); Sarah Elfreth (D-MD-3); Shomari Figures (D-AL-2); Laura Friedman (D-CA-30); Laura Gillen (D-NY-4); Maggie Goodlander (D-NH-2); Adam Gray (D-CA-13); Julie Johnson (D-TX-32); George Latimer (D-NY-16); Sam T. Liccardo (D-CA-16); John W. Mannion (D-NY-22); Sarah McBride (D-DE-AL); April McClain Delaney (D-MD-6); Kristen McDonald Rivet (D-MI-8); Dave Min (D-CA-47); Kelly Morrison (D-MN-3); Johnny Olszewski, Jr. (D-MD-2); Nellie Pou (D-NJ-9); Emily Randall (D-WA-6); Josh Riley (D-NY-19); Luz M. Rivas (D-CA-29); Lateefah Simon (D-CA-12); Suhas Subramanyam (D-VA-10); Derek Tran (D-CA-45); Eugene Simon Vindman (D-VA-7); George Whitesides (D-CA-27); James R. Walkinshaw (D-VA-11); Adelita S. Grijalva (D-AZ-7); David Scott (D-GA-13); Sheila Cherfilus-McCormick (D-FL-20).
Not voting (6): Joe Courtney (D-CT-2); Steve Womack (R-AR-3); Gary J. Palmer (R-AL-6); Lucy McBath (D-GA-6); Gregory F. Murphy (R-NC-3); Eric Swalwell (D-CA-14).
Not in office (12): Christian D. Menefee (D-TX-18); Clay Fuller (R-GA-14); Analilia Mejia (D-NJ-11); James Gallagher (R-CA-1); Everton Blair Jr. (D-GA-13); Aisha Wahab (D-CA-14); Raúl M. Grijalva (D-AZ-7); Gerald E. Connolly (D-VA-11); Mikie Sherrill (D-NJ-11); Mark E. Green (R-TN-7); Michael Waltz (R-FL-6); Sylvester Turner (D-TX-18).
Summary
Main subject: Amends federal health coverage laws to allow employer association health plans, change the treatment of stop-loss insurance and health reimbursement arrangements, require pharmacy benefit management reporting to group health plans, and fund cost-sharing reduction payments. Sec. 101, Sec. 102, Sec. 103, Sec. 201, Sec. 202
Its core areas: Association health plans for groups of employers; Medical stop-loss insurance for self-insured group health plans; Health reimbursement arrangements paired with individual market coverage; Pharmacy benefit management reporting to group health plans; Funding of cost-sharing reduction payments under the Patient Protection and Affordable Care Act.
Unexpected Items: 3 provisions
These provisions fall outside the bill’s main subject or apply narrowly. This describes the text; it is not a judgment.
Exception or delay for a subset (3)
- Sec. 202: Funding cost sharing reduction payments: Appropriates such sums as may be necessary for cost-sharing reduction payments for plan years beginning on or after January 1, 2027, but bars use of the funds for qualified health plans that cover abortion, except where needed to save the mother's life or where the pregnancy results from rape or incest.
- Sec. 201: Oversight of pharmacy benefit management services: Within the pharmacy benefit reporting rules, directs the Secretary to define a limited form of the required report for group health plans whose sponsor is, or is affiliated with, a drug manufacturer, wholesaler, or other drug supply chain participant.
- Sec. 103: Treatment of health reimbursement arrangements integrated with individual market coverage: Amends the Internal Revenue Code's cafeteria plan rules so that the existing restriction on buying Exchange insurance under a cafeteria plan does not apply to employees participating in a custom health option and individual care expense (CHOICE) arrangement.
What it does
- Sec. 101: Amends the Employee Retirement Income Security Act of 1974 to let a group or association of employers maintain a group health plan, whether or not its members share an industry, trade or profession, if it meets listed requirements such as existing at least 2 years and offering coverage to at least 51 employees.
- Sec. 101: Bars association health plans from basing eligibility or premiums on health status-related factors and from denying coverage because of a pre-existing condition.
- Sec. 102: Provides that the definition of health insurance coverage does not include a stop-loss policy obtained by a self-insured group health plan or its sponsor to reimburse losses above a predetermined level.
- Sec. 102: Provides that the Employee Retirement Income Security Act of 1974 preempts State laws that prevent a group health plan from insuring against the risk of excess or unexpected claims losses.
- Sec. 103: Defines a custom health option and individual care expense arrangement as an employer-funded health reimbursement arrangement that pays for medical care only while the individual has individual market coverage or Medicare, and treats it as meeting certain group health plan requirements, for plan years beginning after December 31, 2025.
- Sec. 201: Requires entities providing pharmacy benefit management services to submit reports to group health plans at least every 6 months, covering drug payments, rebates, fees and other remuneration, for plan years beginning 30 months after enactment.
- Sec. 201: Sets a civil monetary penalty of $10,000 for each day a required report or disclosure is not provided, and a penalty of up to $100,000 for each item of false information.
- Sec. 201: Requires a group health plan, on request, to give a participant or beneficiary a summary document and claims-level information about the participant's own claims from the pharmacy benefit management reports.
- Sec. 202: Appropriates such sums as may be necessary for cost-sharing reduction payments under the Patient Protection and Affordable Care Act for plan years beginning on or after January 1, 2027, and bars use of the funds for qualified health plans that cover abortion, except to save the mother's life or in cases of rape or incest.
Written automatically from the official text by Claude Sonnet 5.5, an AI model. Written 12 Oct 2026 and published after the automatic checks, without a person reading it first. Every line names the section it came from.