Medical Foods and Formulas Access Act of 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.