The House passed H.R.987, the Strengthening Health Care and Lowering Prescription Drug Costs Act. This bill includes a number of provisions intended to lower the price of prescription drugs by helping to bring generic and biosimilar drugs to market more quickly, and it seeks to bolster enrollment in Affordable Care Act marketplaces by restoring funding to promote ACA health plans and help individuals find affordable plans while also providing funding for states to establish their own state-operated health insurance marketplaces (rather than relying on the existing federal marketplace). In addition, it revokes a Trump administration rule that expands the availability of short-term health plans that don't have to comply with ACA consumer protections, such as protections for individuals with preexisting conditions.

In general, the savings to the government that would be generated by bringing generic drugs to the market more quickly are used by the bill to offset the increased spending for ACA outreach and enrollment navigators and the development of state-operated exchanges. As of press time Friday, the Congressional Budget Office (CBO) had not released a cost estimate for the combined seven-bill measure.

Supporters

 Supporters of the bill, primarily Democrats, say it will facilitate faster development and marketing of generic and biosimilar drugs and thereby help bring down drug prices, while also promoting enrollment in ACA health exchanges — which will reverse Trump's enrollment sabotage and help make affordable insurance available to more Americans. The navigator program and federal advertising and outreach efforts have been crucial in helping Americans understand the ACA and determine the best plan for their needs, but deep cuts to those programs have made it more difficult for Americans to get insurance through the ACA exchanges. They note that CBO estimates that expanding advertising and outreach alone will increase enrollment in ACA individual health plans and Medicaid by some 500,000 a year through 2029 and help reduce insurance premiums by 1% a year. Enabling more states to operate their own exchanges will also increase access to insurance and lower health care costs, they say, since state-based exchanges can be tailored to better serve the unique needs of their citizens and have been more effective at increasing enrollment and lowering costs than the federal HealthCare.gov portal.

 Supporters also argue that revoking the administration's rule that expands junk health insurance will protect people from purchasing insurance that will provide little to no coverage when they really need it. Short-term, limited duration insurance plans were intended to provide temporary coverage in an emergency, such as when people are between jobs. By allowing individuals to carry such insurance for up to three years, rather than just three months, it appears similar to regular insurance — yet studies have shown that individuals buying such policies are not aware that it would not cover their preexisting conditions. And because of its lower cost, such policies will siphon off the healthiest individuals from the health insurance exchanges, thereby increases premiums for everyone else who needs full, comprehensive insurance.

Opponents

Opponents of the bill, primarily Republicans, say they support the bipartisan provisions aimed at more quickly facilitating the development and marketing of generic and biosimilar drugs in order to reduce prescription drug prices, but say that by including partisan provisions dealing with ACA exchanges, Democrats have undermined the bill and ensured it will never be signed into law. The ACA's health care exchanges and the insurance policies sold through them, like the whole of the ACA, are too expensive and don't function well, they say, and it makes no sense to throw more money at the problem — money they argue would be much better spent addressing the opioid crisis, for which the need is great and the results more apparent and immediate. Moreover, spending hundreds of millions of dollars on navigators, education and outreach are now unnecessary, they argue, since with elimination of the individual mandate people are no longer required to purchase health care insurance. They contend the navigator program in particular is wasteful and inefficient, but say if it must be funded the navigators should be required to help consumers by promoting all health insurance options, including association and short-term plans.

 Opponents also object to bill provisions that would revoke Trump administration rules to make short-term, limited duration insurance plans more readily available to people seeking insurance. They say the most common complaint about health insurance under the ACA is that people cannot afford it because they are forced to purchase plans that cover things they don't want or need, and argue that younger, healthier people should not be required to pay for health care they don't want or need in order to subsidize the health care of older, sicker people. Despite no longer being required to have health insurance, they say people who want some form of minimal coverage should have equal access to the lower-cost short-term health insurance plans and association health plans that have been made available under the Trump administration.