S2756119th CongressWALLET

Affordable Inhalers and Nebulizers Act of 2025

Sponsored By: Senator Angela Alsobrooks

Introduced

Summary

This bill would cap patient cost-sharing for prescription inhalers at $15 per 30-day supply across private insurance, Medicare, and Medicaid and create a new reimbursement program to limit what uninsured people pay.

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  • Families and patients: People who use inhalers for asthma or COPD would pay at most $15 per 30-day supply with no deductible, making monthly costs more predictable.
  • Uninsured individuals: A new uninsured inhaler payment program would let registered providers be reimbursed when they limit uninsured patients' liability to $15 per month per product, subject to appropriations.
  • Medicare and low-income beneficiaries: The bill would align Medicare Part D and Part B rules and low-income cost-sharing with the $15 cap and add related Medicaid changes.
  • Employers, insurers, and tax law: It would add matching ERISA and Internal Revenue Code changes and safe harbors so employer plans, insurers, and tax rules work with the new cap.
  • Timing and implementation: Changes would apply to plan years beginning in 2026 and authorize the HHS Secretary to issue implementation guidance.

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Bill Overview

Analyzed Economic Effects

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

Help buying inhalers for uninsured

If enacted, starting January 1, 2026, the Secretary would set up a program letting registered providers submit claims for specified inhalers given to uninsured people. If enacted, payments by the Secretary would depend on available appropriations. If enacted, providers who join must be licensed in their State and agree not to charge an uninsured person more than $15 for a 30‑day supply when the program pays.

Lower inhaler costs for insured people

If enacted, group and individual health plans would have to cover specified inhalers with no deductible and limit cost-sharing to $15 per 30‑day supply. If enacted, any cost-sharing you pay for these inhalers would count toward your plan's out-of-pocket maximum. These rules would apply to plan years beginning on or after January 1, 2026.

Lower inhaler costs for Medicare

If enacted, Medicare Part B would pay the lesser of the actual charge or the payment amount minus $15 for each 30‑day supply of specified inhalers furnished on or after January 1, 2026. If enacted, the Part B deductible would not apply to those inhalers on or after that date. If enacted, starting in plan year 2026, Part D plans could not apply a deductible to specified inhalers and must cap your cost at $15 per 30‑day supply.

Preserve HSA and catastrophic plan rules

If enacted, for plan years beginning on or after January 1, 2026, the law would clarify that specified inhaler coverage fits an existing catastrophic plan safe harbor. If enacted, it would also say a plan does not lose high-deductible health plan status just because it does not charge a deductible for specified inhalers. If enacted, these rules help keep HSA eligibility and plan design choices intact when plans exempt these inhalers.

Sponsors & CoSponsors

Sponsor

Angela Alsobrooks

MD • D

Cosponsors

  • Chris Van Hollen

    MD • D

    Sponsored 9/10/2025

  • Jeanne Shaheen

    NH • D

    Sponsored 2/3/2026

Roll Call Votes

No roll call votes available for this bill.

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