HR5094119th CongressWALLET

Protect Patients from Costly Care Act

Sponsored By: Representative Pappas

Introduced

Summary

Repeals recent changes to Medicaid cost-sharing and the orphan-drug exclusion in the Medicare drug price negotiation program. This bill would apply Title XIX and Title XI of the Social Security Act as if Sections 71120 and 71203 of Public Law 119-21 had never been enacted and would rescind the amounts appropriated under section 71120(c) of that law.

Show full summary
  • Families and Medicaid enrollees: Would restore the prior Medicaid cost-sharing rules, which could change out-of-pocket charges for eligible households.
  • Patients who use orphan drugs: Would restore the previous treatment of orphan drugs in Medicare's drug price negotiation program, reversing the amendment made by Section 71203.
  • Federal finances: Would rescind the appropriation created by section 71120(c) of Public Law 119-21, removing that funding tied to the repealed Medicaid change.

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Bill Overview

Analyzed Economic Effects

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

Roll back Medicaid cost-sharing changes

The bill would undo recent Medicaid cost-sharing rules from Public Law 119-21. States would apply the prior Medicaid rules for copays and other charges. If you are on Medicaid, your out-of-pocket costs could be lower or stay the same versus those changes. The bill would also cancel the funding tied to those cost-sharing changes. These changes would take effect upon enactment.

Reverse Medicare drug negotiation rule change

The bill would undo a change to the Medicare Drug Price Negotiation Program involving orphan drugs. Agencies would apply the older rules instead. This mainly changes program policy and compliance. Any effect on drug prices for patients would be indirect and could vary. It would take effect upon enactment.

Sponsors & CoSponsors

Sponsor

Pappas

NH • D

Cosponsors

  • Jackson (IL)

    IL • D

    Sponsored 9/2/2025

  • Ruiz

    CA • D

    Sponsored 9/2/2025

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

    DC • D

    Sponsored 9/2/2025

  • Fields

    LA • D

    Sponsored 9/2/2025

  • Larson (CT)

    CT • D

    Sponsored 9/2/2025

  • Carson

    IN • D

    Sponsored 9/2/2025

  • Thanedar

    MI • D

    Sponsored 9/2/2025

  • Craig

    MN • D

    Sponsored 9/2/2025

  • Goodlander

    NH • D

    Sponsored 9/2/2025

Roll Call Votes

No roll call votes available for this bill.

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