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HELP Copays Act

H.R. 6423 Rep. Thomas Kean (R-NJ-7) In committee
Bill text PDF
  1. Introduced Dec 4
  2. Committee Dec 4
  3. Passed House Next
  4. Passed Senate Not yet
  5. To President Not yet
  6. Law Not yet
Where it stands
In committee, Dec 4, 2025Next: House vote
327d ago Dec 4, 2025: Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Final votes
No roll callsNo recorded vote on this bill yet
Lobbying
3companies, 10 filings
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Member trades
2trades in the last 90 days
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Companies lobbying on this bill

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Biotech & Pharma 3
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Summary

This bill requires health insurance plans to count financial assistance from non-profit organizations and drug manufacturers toward a patient's deductible, coinsurance, copayment, and out-of-pocket limit. It amends the Public Health Service Act and the Affordable Care Act to ensure that amounts paid by or on behalf of an enrollee, including such assistance, are included in those cost-sharing definitions.

Sec. 2, Application of financial assistance toward cost-sharing requirements: The bill amends three laws. First, it changes the Public Health Service Act to require that standards for defining deductible, coinsurance, copayment, and out-of-pocket limit include amounts paid by or on behalf of an enrollee, including financial assistance from non-profits and drug manufacturers. Second, it amends the Affordable Care Act to apply the same rule to those terms and similar charges. Third, it amends the Internal Revenue Code to create a safe harbor for high deductible health plans: for plan years after 2025, a plan will not lose its high deductible status by counting such financial assistance for outpatient prescription drugs toward the minimum deductible.

Rule of construction: The amendments apply to standards for specialty drugs and drugs subject to utilization management, but do not affect the use of utilization management tools like prior authorization or step therapy.

Effective date: The section and its amendments apply to plan years beginning on or after January 1, 2026.

Summary of the bill text as introduced in House (Dec 4, 2025), generated by SecBot from the official bill text; the Library of Congress summary is not yet published.

Official record from Congress.gov, the House Clerk and the Senate; lobbying from Lobbying Disclosure Act filings. Updated Oct 27, 2026.