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Medical Foods and Formulas Access Act of 2025

USA119th CongressHR-5684| House 
| Updated: 10/3/2025
James P. McGovern

James P. McGovern

Democratic Representative

Massachusetts

Cosponsors (10)
John W. Mannion (Democratic)Dwight Evans (Democratic)Debbie Dingell (Democratic)Jake Auchincloss (Democratic)Joseph D. Morelle (Democratic)Morgan McGarvey (Democratic)John H. Rutherford (Republican)Brian K. Fitzpatrick (Republican)Seth Moulton (Democratic)Chellie Pingree (Democratic)

Ways and Means Committee, Energy and Commerce Committee, Oversight and Government Reform Committee

  • Introduced
  • In Committee
  • On Floor
  • Passed Chamber
  • Enacted
The Medical Foods and Formulas Access Act of 2025 seeks to ensure comprehensive coverage for medically necessary food , vitamins, and individual amino acids for patients diagnosed with certain digestive and inherited metabolic disorders. These conditions often prevent individuals, particularly children, from properly digesting or metabolizing essential nutrients, making specialized food their primary treatment. Without such treatment, patients face severe risks including malnutrition, developmental delays, cognitive impairment, repeated hospitalizations, and even death, highlighting the critical need for consistent access. The bill expands coverage under several federal health programs. For Medicare , it amends the Social Security Act to include medically necessary food and related equipment, defining it as specially formulated products prescribed by a healthcare practitioner for specific conditions, excluding general dietary or weight loss products. Similarly, Medicaid and the Children's Health Insurance Program (CHIP) are mandated to cover these items, with specific effective dates ranging from one to three years after enactment, allowing for state legislative adjustments where necessary. Furthermore, the Act requires contracts for plans under the Federal Employees Health Benefits Program (FEHBP) to provide this coverage. While not mandating private insurance, Congress expresses a sense that all health plans should cover medically necessary food for these conditions, mirroring the federal provisions. The bill also explicitly states that it does not preempt state laws offering greater coverage for medically necessary food, ensuring that existing protections are maintained or enhanced.
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Timeline
Oct 3, 2025
Introduced in House
Oct 3, 2025
Referred to the Committee on Energy and Commerce, and in addition to the Committees on Ways and Means, and Oversight and Government Reform, 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.
Dec 2, 2025

Latest Companion Bill Action

S 119-3304
Introduced in Senate
  • October 3, 2025
    Introduced in House


  • October 3, 2025
    Referred to the Committee on Energy and Commerce, and in addition to the Committees on Ways and Means, and Oversight and Government Reform, 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.


  • December 2, 2025

    Latest Companion Bill Action

    S 119-3304
    Introduced in Senate

Health

Related Bills

  • S 119-3304: Medical Foods and Formulas Access Act of 2025

Medical Foods and Formulas Access Act of 2025

USA119th CongressHR-5684| House 
| Updated: 10/3/2025
The Medical Foods and Formulas Access Act of 2025 seeks to ensure comprehensive coverage for medically necessary food , vitamins, and individual amino acids for patients diagnosed with certain digestive and inherited metabolic disorders. These conditions often prevent individuals, particularly children, from properly digesting or metabolizing essential nutrients, making specialized food their primary treatment. Without such treatment, patients face severe risks including malnutrition, developmental delays, cognitive impairment, repeated hospitalizations, and even death, highlighting the critical need for consistent access. The bill expands coverage under several federal health programs. For Medicare , it amends the Social Security Act to include medically necessary food and related equipment, defining it as specially formulated products prescribed by a healthcare practitioner for specific conditions, excluding general dietary or weight loss products. Similarly, Medicaid and the Children's Health Insurance Program (CHIP) are mandated to cover these items, with specific effective dates ranging from one to three years after enactment, allowing for state legislative adjustments where necessary. Furthermore, the Act requires contracts for plans under the Federal Employees Health Benefits Program (FEHBP) to provide this coverage. While not mandating private insurance, Congress expresses a sense that all health plans should cover medically necessary food for these conditions, mirroring the federal provisions. The bill also explicitly states that it does not preempt state laws offering greater coverage for medically necessary food, ensuring that existing protections are maintained or enhanced.
View Full Text

Suggested Questions

Get AI-generated questions to help you understand this bill better

Timeline
Oct 3, 2025
Introduced in House
Oct 3, 2025
Referred to the Committee on Energy and Commerce, and in addition to the Committees on Ways and Means, and Oversight and Government Reform, 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.
Dec 2, 2025

Latest Companion Bill Action

S 119-3304
Introduced in Senate
  • October 3, 2025
    Introduced in House


  • October 3, 2025
    Referred to the Committee on Energy and Commerce, and in addition to the Committees on Ways and Means, and Oversight and Government Reform, 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.


  • December 2, 2025

    Latest Companion Bill Action

    S 119-3304
    Introduced in Senate
James P. McGovern

James P. McGovern

Democratic Representative

Massachusetts

Cosponsors (10)
John W. Mannion (Democratic)Dwight Evans (Democratic)Debbie Dingell (Democratic)Jake Auchincloss (Democratic)Joseph D. Morelle (Democratic)Morgan McGarvey (Democratic)John H. Rutherford (Republican)Brian K. Fitzpatrick (Republican)Seth Moulton (Democratic)Chellie Pingree (Democratic)

Ways and Means Committee, Energy and Commerce Committee, Oversight and Government Reform Committee

Health

Related Bills

  • S 119-3304: Medical Foods and Formulas Access Act of 2025
  • Introduced
  • In Committee
  • On Floor
  • Passed Chamber
  • Enacted