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HR4101119th CongressWALLET

Cancer Drug Parity Act of 2025

Sponsored By: Representative Rep. Grothman, Glenn [R-WI-6]

Introduced

Summary

Parity in cost-sharing for FDA‑approved oral anticancer medications. This bill would require group health plans to ensure cost-sharing for prescribed, patient‑administered oral anticancer drugs is no less favorable than cost-sharing for anticancer drugs given intravenously or by injection.

Show full summary
  • Patients and families: Would make copayments, coinsurance, deductibles, and similar out-of-pocket limits for oral anticancer drugs at least as favorable as for IV or injected cancer treatments. This change applies to plan years beginning on or after January 1, 2026.
  • Employers and insurers: Could not raise out-of-pocket costs, reclassify benefits to increase costs, or apply more restrictive limits to oral anticancer drugs to comply. Plans may still use prior authorization and other appropriate utilization controls consistent with existing law.
  • Policymakers and researchers: Directs the Government Accountability Office to study the law's impact on out-of-pocket costs for covered group health plan enrollees and to report findings and recommendations within 2 years after enactment.

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Bill Overview

Analyzed Economic Effects

1 provisions identified: 1 benefits, 0 costs, 0 mixed.

Equal costs for oral cancer pills in job-based plans

If enacted, job-based health plans would match cost-sharing for oral cancer pills to IV or injected chemo. This would apply only to FDA-approved, patient-administered drugs your doctor finds medically necessary or clinically appropriate. Plans could still use prior authorization, and stronger state protections would still apply. Plans could not raise out-of-pocket costs, reclassify benefits, or add tighter limits to dodge parity. The rule would start for plan years on or after January 1, 2026.

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Sponsors & CoSponsors

Sponsor

Rep. Grothman, Glenn [R-WI-6]

WI • R

Cosponsors

  • Rep. Bonamici, Suzanne [D-OR-1]

    OR • D

    Sponsored 6/24/2025

  • Bilirakis

    FL • R

    Sponsored 6/24/2025

  • Rep. Fitzpatrick, Brian K. [R-PA-1]

    PA • R

    Sponsored 6/24/2025

  • Rep. Morelle, Joseph D. [D-NY-25]

    NY • D

    Sponsored 6/24/2025

  • Rep. Matsui, Doris O. [D-CA-7]

    CA • D

    Sponsored 6/24/2025

  • Rep. Brownley, Julia [D-CA-26]

    CA • D

    Sponsored 6/24/2025

  • Rep. Moore, Gwen [D-WI-4]

    WI • D

    Sponsored 6/24/2025

  • Rep. Davis, Donald G. [D-NC-1]

    NC • D

    Sponsored 6/24/2025

  • Rep. Davids, Sharice [D-KS-3]

    KS • D

    Sponsored 6/24/2025

  • Wilson (SC)

    SC • R

    Sponsored 6/24/2025

  • Rep. Kennedy, Timothy M. [D-NY-26]

    NY • D

    Sponsored 6/25/2025

  • Rep. Castor, Kathy [D-FL-14]

    FL • D

    Sponsored 6/25/2025

  • Rep. Raskin, Jamie [D-MD-8]

    MD • D

    Sponsored 9/9/2025

  • Del. Norton, Eleanor Holmes [D-DC-At Large]

    DC • D

    Sponsored 9/15/2025

  • Rep. Balint, Becca [D-VT-At Large]

    VT • D

    Sponsored 9/15/2025

  • Bresnahan

    PA • R

    Sponsored 9/30/2025

  • Rep. Vindman, Eugene Simon [D-VA-7]

    VA • D

    Sponsored 10/3/2025

  • Rep. Ross, Deborah K. [D-NC-2]

    NC • D

    Sponsored 10/8/2025

  • Rep. Garamendi, John [D-CA-8]

    CA • D

    Sponsored 10/17/2025

  • Rep. Houlahan, Chrissy [D-PA-6]

    PA • D

    Sponsored 10/21/2025

  • Rep. Jackson, Jonathan L. [D-IL-1]

    IL • D

    Sponsored 10/24/2025

  • Conaway

    NJ • D

    Sponsored 11/7/2025

  • Rep. Salinas, Andrea [D-OR-6]

    OR • D

    Sponsored 11/7/2025

  • Bynum

    OR • D

    Sponsored 11/7/2025

  • Rep. Neguse, Joe [D-CO-2]

    CO • D

    Sponsored 12/18/2025

  • Rep. Pappas, Chris [D-NH-1]

    NH • D

    Sponsored 12/18/2025

  • Schmidt

    KS • R

    Sponsored 3/16/2026

Roll Call Votes

No roll call votes available for this bill.

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