To provide for insurance reform (including health insurance reform), amend title XVIII of the Social Security Act to reform Medicare Advantage and reduce disparities in the Medicare Program, regulate the importation of prescription drugs, and for other purposes.

Amends the McCarran-Ferguson Act to restore application of the Clayton Act and other antitrust laws to insurers.

Prohibits premium variation except by geographic premium rating area and by family enrollment.

Requires each health benefits plan issuer that offers health insurance coverage in the individual or group market in a state to accept every employer and individual in the state that applies for such coverage.

Places restrictions on federal funding of abortion, except in cases of certain physical conditions, rape, or incest.

Limits a health benefits plan to selling health insurance coverage to U.S. citizens and lawful resident aliens.

Amends title XVIII (Medicare) and title XIX (Medicaid) of the Social Security Act to revise requirements for: (1) Medicare Advantage, with respect to the blended benchmark amount and elimination of the MA Regional Plan Stabilization Fund; (2) an increase in the physician fee schedule practice expense geographic adjustment; (3) establishment of a Medicare operated prescription drug plan option; and (4) pharmacy reimbursement.

Amends the Federal Food, Drug, and Cosmetic Act (FFDCA) to revise requirements for the importation of prescription drugs. Requires the registration of importers and exporters.

Prescribes requirements for: (1) the disposition of certain drugs denied admission into the United States; (2) alternative identification of the chain of custody of certain prescription drugs, including through the use of standardized anti-counterfeiting or track-and-trace technologies; and (3) the sale of prescription drugs through an Internet site.

Prohibits the introduction of restricted transactions with unregistered foreign pharmacies into a payment system or the completion of such transactions using a payment system.

Amends the Internal Revenue Code to disallow a deduction from income for advertising and promotional expenses for
prescription pharmaceuticals.

Requires a pharmacy benefit manager with a contract with a health benefits plan to comply with fiduciary standards established by the Secretary of Health and Human Services (HHS).

Amends SSA title XIX (Medicaid) to require any drug manufacturer with a rebate agreement concerning covered outpatient drugs to report to the HHS Secretary following a rebate period the total number of units used to calculate the monthly average manufacturer price for each covered outpatient drug.