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119-s-864119th CongressWALLET

HELP Copays Act

Sponsored By: Senator Marshall, Roger [R-KS]

In Committee

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

Marshall, Roger [R-KS]

KS • R

Cosponsors

  • Sen. Kaine, Tim [D-VA]

    VA • D

    Sponsored 3/5/2025

  • Sen. Tillis, Thomas [R-NC]

    NC • R

    Sponsored 3/5/2025

  • Sen. Markey, Edward J. [D-MA]

    MA • D

    Sponsored 3/5/2025

  • Sen. Murkowski, Lisa [R-AK]

    AK • R

    Sponsored 3/5/2025

  • Sen. Merkley, Jeff [D-OR]

    OR • D

    Sponsored 3/5/2025

  • Sen. Capito, Shelley Moore [R-WV]

    WV • R

    Sponsored 3/13/2025

  • Sen. Coons, Christopher A. [D-DE]

    DE • D

    Sponsored 3/13/2025

  • Sen. Budd, Ted [R-NC]

    NC • R

    Sponsored 3/13/2025

  • Sen. Murray, Patty [D-WA]

    WA • D

    Sponsored 3/13/2025

  • Sen. Boozman, John [R-AR]

    AR • R

    Sponsored 3/31/2025

  • Sen. Shaheen, Jeanne [D-NH]

    NH • D

    Sponsored 3/31/2025

  • Sen. Padilla, Alex [D-CA]

    CA • D

    Sponsored 11/7/2025

  • Sen. Gallego, Ruben [D-AZ]

    AZ • D

    Sponsored 12/15/2025

  • Sen. Peters, Gary C. [D-MI]

    MI • D

    Sponsored 12/15/2025

  • Sen. Kelly, Mark [D-AZ]

    AZ • D

    Sponsored 12/15/2025

  • Sen. Blumenthal, Richard [D-CT]

    CT • D

    Sponsored 1/28/2026

  • Sen. Rounds, Mike [R-SD]

    SD • R

    Sponsored 3/5/2026

  • Sen. Schiff, Adam B. [D-CA]

    CA • D

    Sponsored 3/5/2026

  • Sen. Booker, Cory A. [D-NJ]

    NJ • D

    Sponsored 3/10/2026

  • Sen. Whitehouse, Sheldon [D-RI]

    RI • D

    Sponsored 3/24/2026

  • Sen. Bennet, Michael F. [D-CO]

    CO • D

    Sponsored 3/26/2026

  • Sen. Heinrich, Martin [D-NM]

    NM • D

    Sponsored 4/13/2026

  • Sen. Husted, Jon [R-OH]

    OH • R

    Sponsored 4/30/2026

  • Sen. Gillibrand, Kirsten E. [D-NY]

    NY • D

    Sponsored 5/11/2026

  • Sen. Smith, Tina [D-MN]

    MN • D

    Sponsored 5/12/2026

  • Sen. Warnock, Raphael G. [D-GA]

    GA • D

    Sponsored 6/23/2026

  • Sen. Fetterman, John [D-PA]

    PA • D

    Sponsored 7/15/2026

  • Sen. Warren, Elizabeth [D-MA]

    MA • D

    Sponsored 9/22/2026

Roll Call Votes

No roll call votes available for this bill.

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