# 119-hr-5684: Medical Foods and Formulas Access Act of 2025

119-hr-5684, Medical Foods and Formulas Access Act of 2025, is a 119th Congress bill sponsored by Rep. McGovern, James P. [D-MA-2] (D-MA); status introduced; PRIA reads it as touching household money (as of 2026-10-07).

- Canonical: https://policyrisk.com/legislation/119-hr-5684
- As of: 2026-10-07
- Plain-text twin of the page above; the HTML and this file carry the same facts.

## Facts
- Bill: 119-hr-5684
- Congress: 119
- Title: Medical Foods and Formulas Access Act of 2025
- Status: introduced
- Introduced: 2025-10-03
- Sponsor: Rep. McGovern, James P. [D-MA-2] (D-MA)
- Cosponsors: 19
- Policy area: Health
- Touches household money: yes
- Last recorded action: 2026-10-07

## Summary

**This bill would mandate coverage of medically necessary foods, vitamins, and individual amino acids for people with digestive and inherited metabolic disorders.** It defines medically necessary food broadly to include low-protein modified food products, amino acid preparations, modified-fat preparations, nutritional formulas, vitamins, and single amino acids when prescribed by a clinician for dietary management of a covered condition. - Families and patients: People with inherited metabolic disorders, malabsorption conditions, certain food protein allergies, and inflammatory or immune-mediated gastrointestinal diseases would gain explicit coverage for prescribed medical foods and related supplies. Coverage can apply when foods are used under medical direction, including in the home. - Medicare beneficiaries: Medicare would pay 80 percent of the lesser of a provider’s charge or a Secretary-set fee schedule for medically necessary foods. Medicare payment and coverage rules would begin three years after enactment. - Low-income children, Medicaid enrollees, federal employees, and private-plan members: Medicaid would treat medically necessary food as a mandatory benefit and cover administration equipment two years after enactment. The Children’s Health Insurance Program would require coverage for targeted low-income children after one year. Federal Employees Health Benefits Program contracts would require coverage starting the next contract year. Congress also urges private plans to offer similar coverage and preserves stronger state laws.

## Cosponsors (19)

- Del. Norton, Eleanor Holmes [D-DC-At Large] (D-DC), 2026-10-01T00:00:00.000Z
- Rep. Jackson, Jonathan L. [D-IL-1] (D-IL), 2026-10-01T00:00:00.000Z
- Rep. Randall, Emily [D-WA-6] (D-WA), 2026-10-05T00:00:00.000Z
- Rep. Rutherford, John H. [R-FL-5] (R-FL), 2025-10-03T00:00:00.000Z
- Rep. Dingell, Debbie [D-MI-6] (D-MI), 2025-10-03T00:00:00.000Z
- Rep. Fitzpatrick, Brian K. [R-PA-1] (R-PA), 2025-10-03T00:00:00.000Z
- Rep. Evans, Dwight [D-PA-3] (D-PA), 2025-10-17T00:00:00.000Z
- Rep. Auchincloss, Jake [D-MA-4] (D-MA), 2025-10-17T00:00:00.000Z
- Rep. Pingree, Chellie [D-ME-1] (D-ME), 2025-11-18T00:00:00.000Z
- Rep. McGarvey, Morgan [D-KY-3] (D-KY), 2025-11-18T00:00:00.000Z
- Rep. Moulton, Seth [D-MA-6] (D-MA), 2025-12-03T00:00:00.000Z
- Rep. Mannion, John W. [D-NY-22] (D-NY), 2025-12-15T00:00:00.000Z
- Rep. Morelle, Joseph D. [D-NY-25] (D-NY), 2026-03-18T00:00:00.000Z
- Rep. Walkinshaw, James R. [D-VA-11] (D-VA), 2026-06-08T00:00:00.000Z
- Rep. Schrier, Kim [D-WA-8] (D-WA), 2026-06-30T00:00:00.000Z
- Rep. Carson, André [D-IN-7] (D-IN), 2026-06-30T00:00:00.000Z
- Rep. Tlaib, Rashida [D-MI-12] (D-MI), 2026-07-06T00:00:00.000Z
- Rep. McBride, Sarah [D-DE-At Large] (D-DE), 2026-09-10T00:00:00.000Z
- Rep. Williams, Nikema [D-GA-5] (D-GA), 2026-09-21T00:00:00.000Z

## Provisions PRIA read

- Definition of medically necessary foods: benefit, high. If enacted, the bill would create a federal definition of "medically necessary food." It would cover special formulas, low-protein products, amino acids, vitamins, and similar items when ordered by a clinician for listed diseases. The definition requires products be for partial or full oral or tube…
- Medicare pays for medical foods: benefit, high. If enacted, Medicare would cover medically necessary foods and the supplies to give them. Medicare would pay 80% of the lesser of the actual charge or a Secretary-set fee. You would generally pay the remaining 20% per item. This change would apply to items furnished three years after enactment.
- CHIP must cover medical foods: benefit, medium. If enacted, CHIP would have to cover medically necessary foods and the equipment to give them for targeted low-income children. This requirement would start one year after enactment. States that need new State laws would have a short delay until after their next legislative session.
- Medicaid must cover medical foods: benefit, medium. If enacted, Medicaid would be required to cover medically necessary foods and the equipment and supplies needed to give them. States could not use benchmark plans unless those plans include this coverage. The rule would take effect two years after enactment, but States that need new State laws woul…
- FEHBP plans must cover foods: benefit, low. If enacted, Federal Employees Health Benefits Program plans would have to cover medically necessary foods and the equipment to give them. The requirement would apply to contract years beginning one year after enactment. Coverage would apply when a clinician prescribes the food.
- States keep stronger food rules: benefit, low. If enacted, the bill would not override State laws that require more coverage of medically necessary food than the federal rules. States with stronger protections would keep those rules.

## Related bills

- 119-hr-1661: SAFE Act of 2025
- 119-hr-7973: Momnibus Act
- 119-hr-7977: Energy Bills Relief Act
- 119-hr-4206: CONNECT for Health Act of 2025
- 119-hr-1589: American Dream and Promise Act of 2025
- 119-hr-1262: Mikaela Naylon Give Kids a Chance Act

## Sources
- [119-hr-5684 on Congress.gov](https://www.congress.gov/bill/119th-congress/house-bill/5684)

## Related
- [119-hr-1661: SAFE Act of 2025](https://policyrisk.com/legislation/119-hr-1661)
- [119-hr-7973: Momnibus Act](https://policyrisk.com/legislation/119-hr-7973)
- [119-hr-7977: Energy Bills Relief Act](https://policyrisk.com/legislation/119-hr-7977)
- [119-hr-4206: CONNECT for Health Act of 2025](https://policyrisk.com/legislation/119-hr-4206)
- [119-hr-1589: American Dream and Promise Act of 2025](https://policyrisk.com/legislation/119-hr-1589)
- [119-hr-1262: Mikaela Naylon Give Kids a Chance Act](https://policyrisk.com/legislation/119-hr-1262)
- [All bills in Congress](https://policyrisk.com/legislation)

Source: PRIA, https://policyrisk.com/legislation/119-hr-5684 (as of 2026-10-07).