Lower Health Care Premiums for All Americans Act

This bill aims to improve access to affordable health insurance by modifying rules for association health plans, medical stop-loss insurance, health reimbursement arrangements, pharmacy benefit management oversight, and funding for cost-sharing reduction payments.

Title I, Improving Health Care Options for Workers: Sec. 101, Association Health Plans: Amends ERISA to allow groups or associations of employers, regardless of industry, to form group health plans if they meet requirements such as being formed for non-insurance purposes, having a formal structure, existing for at least 2 years, covering at least 51 employees and all employees of members, and not discriminating based on health status. Premium rates may use modified community rating and adjust based on employer risk profiles.

Sec. 102, Certain Medical Stop-Loss Insurance: Excludes stop-loss policies obtained by self-insured group health plans from the definition of health insurance coverage under ERISA, and preempts state laws that prevent group health plans from insuring against excess claims losses.

Sec. 103, Treatment of Health Reimbursement Arrangements Integrated with Individual Market Coverage: Treats certain employer-funded health reimbursement arrangements (called custom health option and individual care expense arrangements) as meeting specific health insurance requirements, provided they are offered on nondiscriminatory terms, require individual market or Medicare coverage, and meet substantiation and notice requirements.

Title II, Lowering Health Care Premiums for Everyone: Sec. 201, Oversight of Pharmacy Benefit Management Services: Requires group health plans and pharmacy benefit managers to include contract provisions ensuring information disclosure and to submit detailed reports every 6 months (or quarterly if requested) on drug claims, including compensation, pricing, rebates, and out-of-pocket spending, in plain language and machine-readable format.

Sec. 202, Funding Cost Sharing Reduction Payments: Appropriates necessary funds from the Treasury for cost-sharing reduction payments under the Affordable Care Act for plan years starting on or after January 1, 2027, but prohibits using these funds for plans covering abortion, except to save the mother's life or in cases of rape or incest.