HR5278119th CongressWALLET

Affordable Inhalers and Nebulizers Act of 2025

Sponsored By: Representative Mfume

Introduced

Summary

Caps patient out-of-pocket costs for inhalers at $15 per 30-day supply. This bill would align private group plans, Medicare, and a new uninsured program around that uniform cap and would bar deductibles for these covered inhalers and related equipment starting in 2026.

Show full summary
  • Families and patients with asthma or COPD would pay no more than $15 per 30-day supply for covered inhalers and devices. Plans could not apply a deductible for these products and any cost sharing would count toward the plan’s out-of-pocket maximum; private plan rules take effect for plan years beginning on or after January 1, 2026.
  • Medicare beneficiaries would see deductible relief and lower cost sharing for inhalers. For Part B, provider payments would be adjusted to reflect a $15 reduction per 30-day supply and the Part B deductible would not apply starting in 2026; for Part D, deductibles would be waived for specified inhalers and cost sharing would be capped at $15 per month.
  • Uninsured individuals would gain access through a new federal payment program that requires registered providers to furnish specified inhalers at no more than $15 per month, with providers reimbursed by the Secretary subject to appropriations.

Your PRIA Score

Score Hidden

Personalized for You

How does this bill affect your finances?

Sign up for a PRIA Policy Scan to see your personalized alignment score for this bill and every other piece of legislation we track. We analyze your financial profile against policy provisions to show you exactly what matters to your wallet.

Free to start

Bill Overview

Analyzed Economic Effects

4 provisions identified: 4 benefits, 0 costs, 0 mixed.

Lower inhaler costs in private plans

If enacted, most group and individual plans would have to cover specified inhalers and related gear like spacers and nebulizers. No deductible could apply, and your share would be capped at $15 for a 30-day supply. What you pay would still count toward your plan’s out-of-pocket max and toward any deductible. These rules would start for plan years on or after Jan 1, 2026. HDHPs could keep HSA status when waiving the deductible, and catastrophic plans would be covered by a safe harbor.

Medicare Part B inhalers cost less

For inhalers furnished on or after Jan 1, 2026, Medicare Part B would not apply the deductible. Medicare would pay the usual amount or the actual charge, whichever is less, minus $15 per 30-day supply. Because the payment would be lower, your Part B coinsurance could be lower too. This would apply only when the inhaler is furnished under Part B.

Medicare Part D $15 inhalers

Starting in plan year 2026, Medicare Part D plans would not apply the deductible to specified inhalers. Your cost for a month’s supply would be no more than $15. If you get the low-income subsidy, your copay would also be capped at $15. You must be enrolled in Part D to get these rules.

Help for uninsured to get inhalers

Beginning Jan 1, 2026, HHS would run a program paying registered providers for specified inhalers given to uninsured people. When the program pays, providers could not charge the patient over $15 for a month’s supply. You must be uninsured under the bill’s definition. Payments would depend on funds approved by Congress.

Sponsors & CoSponsors

Sponsor

Mfume

MD • D

Cosponsors

  • Johnson (GA)

    GA • D

    Sponsored 9/10/2025

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

    DC • D

    Sponsored 9/10/2025

  • Thanedar

    MI • D

    Sponsored 9/10/2025

  • Elfreth

    MD • D

    Sponsored 9/10/2025

  • McIver

    NJ • D

    Sponsored 9/10/2025

  • Fields

    LA • D

    Sponsored 9/10/2025

  • Davis (IL)

    IL • D

    Sponsored 9/10/2025

  • Figures

    AL • D

    Sponsored 9/10/2025

  • Olszewski

    MD • D

    Sponsored 9/10/2025

  • Ivey

    MD • D

    Sponsored 9/10/2025

  • McClain Delaney

    MD • D

    Sponsored 9/10/2025

  • Foushee

    NC • D

    Sponsored 9/26/2025

  • Lynch

    MA • D

    Sponsored 10/10/2025

Roll Call Votes

No roll call votes available for this bill.

View on Congress.gov
Back to Legislation

Take It Personal

Get Your Personalized Policy View

Start a Free Government Policy Watch to see how policy affects your household, then upgrade to PRIA Full Coverage for year-round monitoring.

Already have an account? Sign in