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119-hr-5139119th CongressWALLET

EPIPEN Act

Sponsored By: Representative Frost, Maxwell [D-FL-10]

Introduced

Summary

Caps in-network out-of-pocket costs for FDA-approved epinephrine delivery systems across major federal health plans. This bill would require group and individual plans governed by the Public Health Service Act, the Employee Retirement Income Security Act, and the Internal Revenue Code to cover epinephrine delivery systems with no deductible and cost sharing capped at $60 per package of two devices, with those payments counting toward plan deductibles and out-of-pocket maximums.

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  • Families and patients: People who need epinephrine would pay at most $60 for a two-pack in-network, and those payments would count toward their deductible or out-of-pocket maximum. Coverage applies to any FDA-approved delivery system, including auto-injectors, nasal sprays, and approved sublingual devices.
  • Employers and group plans: Plans subject to ERISA or the Public Health Service Act would have to adopt the no-deductible rule and the $60 in-network cap for plan years beginning on or after January 1, 2026.
  • Insurers and network rules: The cap applies to in-network coverage; plans may set different, potentially higher, cost sharing for out-of-network epinephrine delivery systems.

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Bill Overview

Analyzed Economic Effects

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

Lower epinephrine costs for insured people

If enacted, group and individual health plans would have to cover FDA‑approved epinephrine devices. You would not owe a deductible for these devices. Your share would be capped at $60 for a 2‑pack (or the equivalent). What you pay would still count toward your plan deductible and out‑of‑pocket limit. Plans would not have to cover out‑of‑network devices and could charge more out‑of‑network. These rules would start for plan years beginning on or after January 1, 2026.

Sponsors & CoSponsors

Sponsor

Frost, Maxwell [D-FL-10]

FL • D

Cosponsors

  • Rep. Matsui, Doris O. [D-CA-7]

    CA • D

    Sponsored 9/4/2025

Roll Call Votes

No roll call votes available for this bill.

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