HELP Copays Act
Sponsored By: Senator Roger Marshall
Introduced
Summary
Counts patient assistance from nonprofits and drug makers toward a person's deductible, coinsurance, copay, and out-of-pocket maximum. It would force group and individual health plans to treat payments made on behalf of enrollees as reducing their cost-sharing obligations.
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Bill Overview
Analyzed Economic Effects
2 provisions identified: 2 benefits, 0 costs, 0 mixed.
Charity and drug payments count toward costs
If enacted, the bill would require group and individual health plans to count money paid by charities or drug makers toward your deductible, coinsurance, copay, and out‑of‑pocket limit. This would explicitly include nonprofit financial help and manufacturer assistance for prescription drugs, including specialty drugs and drugs under prior authorization or step therapy. Insurers would still be able to use utilization management tools like prior authorization and step therapy. The rule would apply to plan years beginning on or after January 1, 2026.
Keep Health Savings Account eligibility
If enacted, the bill would add a safe harbor so a plan will not lose high‑deductible health plan status just because third‑party payments are counted toward the deductible. That would help people keep Health Savings Account (HSA) eligibility when charities or drug makers help pay outpatient prescription drug costs. The safe harbor applies to plan years beginning after December 31, 2025.
Sponsors & CoSponsors
Sponsor
Roger Marshall
KS • R
Cosponsors
Timothy Kaine
VA • D
Sponsored 3/5/2025
Thomas Tillis
NC • R
Sponsored 3/5/2025
Edward Markey
MA • D
Sponsored 3/5/2025
Lisa Murkowski
AK • R
Sponsored 3/5/2025
Jeff Merkley
OR • D
Sponsored 3/5/2025
Shelley Capito
WV • R
Sponsored 3/13/2025
Christopher Coons
DE • D
Sponsored 3/13/2025
Ted Budd
NC • R
Sponsored 3/13/2025
Patty Murray
WA • D
Sponsored 3/13/2025
John Boozman
AR • R
Sponsored 3/31/2025
Jeanne Shaheen
NH • D
Sponsored 3/31/2025
Alex Padilla
CA • D
Sponsored 11/7/2025
Ruben Gallego
AZ • D
Sponsored 12/15/2025
Gary Peters
MI • D
Sponsored 12/15/2025
Mark Kelly
AZ • D
Sponsored 12/15/2025
Richard Blumenthal
CT • D
Sponsored 1/28/2026
Mike Rounds
SD • R
Sponsored 3/5/2026
Adam Schiff
CA • D
Sponsored 3/5/2026
Cory Booker
NJ • D
Sponsored 3/10/2026
Sheldon Whitehouse
RI • D
Sponsored 3/24/2026
Michael Bennet
CO • D
Sponsored 3/26/2026
Roll Call Votes
No roll call votes available for this bill.
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