Protecting Health Care for All Patients Act of 2025
Sponsored By: Representative Cammack
Introduced
Summary
This bill would bar the use of Quality-Adjusted Life Years (QALYs) and similar measures in coverage and payment decisions across federal health programs. It also raises annual funding for the Prevention and Public Health Fund and orders recurring federal reports on QALYs' effects.
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- Patients who are elderly, disabled, or terminally ill would be protected from coverage decisions that value their life-years lower than younger or healthier people. States and federal agencies would not be allowed to use QALYs or waive that prohibition.
- Medicaid enrollees, children in CHIP, Medicare Advantage enrollees, and people on Part D would see the rule applied to their programs; Medicaid managed care organizations, MA plans, and prescription drug plans could not use dollars-per-QALY measures in coverage or payment decisions.
- The Prevention and Public Health Fund would receive $1.1 billion in FY2026–27 rising to $1.5 billion by FY2030–31 to support public health activities. The Comptroller General must report to Congress within 1 year and annually after on how QALYs affect people with intellectual and developmental disabilities.
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Bill Overview
Analyzed Economic Effects
2 provisions identified: 2 benefits, 0 costs, 0 mixed.
Six-year funding for public health
If enacted, the government would set yearly amounts for the Prevention and Public Health Fund for 2026 through 2031. Funding would be $1.102 billion each in 2026 and 2027. Funding would be $1.327 billion each in 2028 and 2029. Funding would be $1.526 billion each in 2030 and 2031. This money would support public health programs run by states, localities, and community groups. The change would take effect upon enactment.
No QALY scores in federal coverage
If enacted, federal health programs would be banned from using quality-adjusted life year (QALY) scores or similar measures. The ban would cover coverage and payment decisions. It would apply to Medicare Advantage, Part D drug plans, Medicaid, CHIP, and other federal programs, including the Federal Employee Health Benefits program. Agencies and states would not be allowed to use waivers or demonstrations to get around this rule. The ban would start January 1, 2027. It targets measures that treat extending the life of an elderly, disabled, or terminally ill person as worth less than for others.
Sponsors & CoSponsors
Sponsor
Cammack
FL • R
Cosponsors
Hern (OK)
OK • R
Sponsored 6/10/2025
Harris (MD)
MD • R
Sponsored 3/17/2026
Roll Call Votes
No roll call votes available for this bill.
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