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Lower Drug Copays: Financial Aid Counts Towards Health Costs

New rules aim to reduce out-of-pocket healthcare costs for patients. Financial assistance, such as from non-profit organizations or drug manufacturers, will now count towards deductibles, copayments, and out-of-pocket limits, potentially easing the financial burden of health insurance. These changes apply to health plans starting January 1, 2026.
Key points
Financial assistance from non-profits and drug manufacturers will count towards your deductibles, coinsurance, copayments, and out-of-pocket limits.
This applies to specialty drugs and drugs subject to utilization management (e.g., requiring prior authorization).
The changes take effect for health plans beginning on or after January 1, 2026.
article Official text account_balance Process page
Introduced
Citizen Poll
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Additional Information
Print number: 119_S_864
Sponsor: Sen. Marshall, Roger [R-KS]
Process start date: 2025-03-05
Lustra uses Artificial Intelligence. Verify details in source documents.
Summarized by: gemini-2.5-flash-preview-05-20
Source data: api.congress.gov
AI work logs for this document launch

OFFICIAL LEGAL TITLE

HELP Copays Act

FREQUENTLY ASKED QUESTIONS

What is the official ID of this bill?

The official print number for this legislation is 119_S_864.

Which chamber initiated this legislation?

This legislation was initiated in the Senate.

When did the legislative process begin?

The process officially started on 2025-03-05.

What are the main provisions?

Key points include:

  • Financial assistance from non-profits and drug manufacturers will count towards your deductibles, coinsurance, copayments, and out-of-pocket limits.
  • This applies to specialty drugs and drugs subject to utilization management (e.g., requiring prior authorization).
  • The changes take effect for health plans beginning on or after January 1, 2026.
What is the specific legal status?

The current status is Introduced.

Where can I read the full text of this legislation?

The full official text is available at: View full text

Who is the primary sponsor?

The primary sponsor is Sen. Marshall, Roger [R-KS].

What is the latest detailed status?

The latest detailed status is: Introduced in Senate

Is this summary verified?

Yes. This content was analyzed by AI and verified by the Lustra Judge System on 2025-12-23.

CATEGORIES

Health