House GOP plots healthcare overhaul with HSA expansion, PBM crackdown

House Republicans are expected to unveil a road map sometime this month that they say will reduce soaring health care costs.

Speaker of the House of Representatives Mike JohnsonBoth Rep. Steve Scalise, R-Los Angeles, and House Majority Leader Steve Scalise, said they are talking to various factions of the Republican Party to build consensus on what this plan should look like.

Meanwhile, Fox News Digital spoke with several GOP lawmakers about what they think should be in such a package and found many commonalities about what they expect.

“Health Savings Accounts (HSAs) need to be expanded to include the largest number of individual health care recipients or premium payers in our country,” said House Republican Conference Chairman Blake Moore, R-Utah. “As it stands now, it’s only people who have access to a health savings account, and those types of plans are typically high deductible.” “It’s really well used, but it needs to be expanded so that all Americans on some type of health insurance policy can use it Health savings accounts“.

Patients group presses Trump to confront health care ‘fat cats’ and demand real price transparency

Health care costs are expected to rise for Americans across the country starting next year, both Republicans and Democrats warn. (Wodicka/Ullstein Bild via Getty Images)

HSAs are accounts that allow people to set aside pre-tax money to pay for certain health costs, but they are currently only available to people with high-deductible health insurance plans.

Expanding HSA use proved to be a common theme among House Republicans who spoke with Fox News Digital about what they want to see in their party’s health plan.

Another topic that has come up frequently is pharmacy benefit management (PBM) reform, an issue that has received bipartisan support in the past.

PBMs are third parties that act as intermediaries between pharmaceutical companies and insurance coverage administrators, and are often responsible for administrative tasks and negotiating drug prices.

CBO has also been the subject of bipartisan anger in Congress, with both Republicans and Democrats accusing it of being part of a broken system to inflate health care costs.

GOP unveils plan for ‘Trump Health Freedom Accounts’ to replace Obama health care subsidies with state waivers

“I’ve had my own pharmacies for more than 32 years, and I can tell you that lowering prescription drug prices is as simple as tackling the middleman, the PBMs, that cause the increases and cause drug prices to stay high,” said Rep. Buddy Carter, R-Ga. “This is one of the quickest and easiest ways to reduce prescription drug prices by lowering them.”

Republican lawmakers have also called more broadly for creating a competitive market for health insurance plans.

House Speaker Mike Johnson arrives to attend the opening of the 119th Congress on January 3, 2025. (Wayne McNamee/Getty Images)

While few of them said they had any desire to actually repeal and replace Obamacare, most said they wanted Americans to have more choices than just the federal program when choosing their health care.

“We see that Obamacare has been around now for almost 14 years, and it’s more expensive, and we have fewer options than ever before. So Obamacare isn’t working, and I think that’s what we need to focus on,” said Republican Indiana Rep. Marilyn Stutzman. “There are plans already being made by the administration, by groups in the Republican Party, that want to focus on making sure that health care is affordable, that it’s accessible and that people can make a choice rather than being told which doctor to go to.”

Republicans are divided on whether Obamacare should be saved — or replaced — before the backing deadline

Democrats have warned that health care costs are expected to rise for millions of Americans if benefits are not extended. But House Majority Whip Tom Emmer, R-Minn., said costs are about to rise either way if Congress doesn’t act soon.

“All Americans will get a 20 to 30 percent increase in their health insurance premiums next year. Even if we do what they want us to do — and I’m not saying we won’t do it, because the White House may have a plan to pursue that, the Senate may have a plan. Mike Johnson may do something, but even if we do that, you realize that it will only cover about 4 percent of that 20 to 30 percent increase. It doesn’t solve the problem,” Emmer said.

Rep. Austin Scott, R-Ga., told Fox News Digital he wants to see a health care package focused on doctors in rural areas, as well as hospital care reforms.

“I have to make sure that what we’re doing is right for that independent practitioner, that small-town pharmacist. And so we have to make sure that we’re taking care of rural America with what we’re doing, as well as the hospitals that we’re all going to go to if we get, you know, cancer treatment or something like that,” he said.

House Majority Whip Tom Emmer speaks during a news conference at the U.S. Capitol in Washington, October 23, 2025. (Eric Lee/Getty Images)

Click here to download the FOX NEWS app

None of the conservatives who spoke with Fox News Digital expressed support for extending the Obamacare tax credits that were boosted during the COVID-19 pandemic, but they It is scheduled to eventually expire From this year.

However, it’s a campaign led by Democrats and some Republicans, who have offered a range of options, from a one-year extension with some reforms to House Democratic leaders pushing for a clean three-year extension.

But whatever lawmakers come up with is likely to get 60 votes to advance in the Senate, meaning some support from the left is needed.

“There’s a lot of good bipartisan health care policy legislation that could pass imminently and very soon, unless Democrats play the game of ‘Oh, I don’t want it to look like Republicans are productive on health care, so we’re going to obstruct this, even though I agree with the policy,'” Moore said.