SBE Council Support Letter: “Lower Health Care Premiums for All Americans Act”

By SBE Council at 15 December, 2025, 8:21 pm

The Honorable Mike Johnson

Speaker

U.S. House of Representatives

Washington, DC 20515

Dear Speaker Johnson:

On behalf of the Small Business and Entrepreneurship Council (SBE Council), I write in strong support of the "Lower Health Care Premiums for All Americans Act." Escalating healthcare costs undermine small business competitiveness and growth. This longstanding challenge has worsened under the "Affordable Care Act" (ACA). Rather than delivering affordability and choice as promised by supporters, the ACA's rigid and intrusive rules, weak incentives for small businesses, and expensive government bureaucracy has fueled the upsurge in premium prices and undermined choice and access. Pouring expensive subsidies on top of the pricey ACA mess is not a responsible solution.

SBE Council has long supported policies that promote market competition and innovation to ensure that the self-employed, entrepreneurs and their employees can access health coverage options in a cost effective and sustainable way. The "Lower Health Care Premiums for All American Act" is an important step in that direction.

The legislation codifies policy established in 2019 for "Custom Health Option and Individual Care Expense" (CHOICE) arrangements, which allow employers to contribute tax-free funds for workers to buy ACA-compliant individual market plans. Employees are empowered to select plans that best meet their needs and pay premiums on a pretax basis. Moreover, small businesses will be eligible for a tax credit when they offer a CHOICE arrangement, which will provide support in alleviating cost pressures.

The legislation also helps to address high costs by improving transparency. Currently, there is limited visibility into how prescription drug prices are set and how costs are passed through the system. Requiring pharmacy benefit managers (PBMs) to provide clear information on pricing practices, rebates, spread pricing, and formulary decisions will give employers, workers, and the market greater insight into where dollars are going, and will help small businesses better manage health care spending.

The legislation also expands access to Association Health Plans (AHPs) by codifying rules established in 2018, which will encourage greater pool activity and, by extension, more affordable choices for small businesses. In addition, the bill exempts stop-loss plans from "health insurance coverage" (under ERISA) and will help small and mid-sized employers protect themselves against catastrophic claims while continuing to offer tailored benefits.

The "Lower Health Care Premiums for All Americans Act" reflects a sound approach that will improve affordability and choice for small businesses. SBE Council appreciates your leadership in advancing reforms that begin the process of moving away from the financially unsustainable government-centered ACA to an approach that improves health coverage affordability, choices, and access for all Americans.

Sincerely,

Karen Kerrigan, President & CEO