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HELP Copays Act

USA119th CongressHR-6423| House 
| Updated: 12/4/2025
Thomas H. Kean

Thomas H. Kean

Republican Representative

New Jersey

Cosponsors (28)
Mark Pocan (Democratic)Ed Case (Democratic)Mariannette Miller-Meeks (Republican)Jimmy Panetta (Democratic)Steve Cohen (Democratic)Thomas R. Suozzi (Democratic)Haley M. Stevens (Democratic)Jake Auchincloss (Democratic)Ted Lieu (Democratic)Maria Elvira Salazar (Republican)Daniel Meuser (Republican)Joe Wilson (Republican)Doris O. Matsui (Democratic)Suhas Subramanyam (Democratic)Daniel S. Goldman (Democratic)Sharice Davids (Democratic)August Pfluger (Republican)Bonnie Watson Coleman (Democratic)Lateefah Simon (Democratic)Mike Quigley (Democratic)Brian K. Fitzpatrick (Republican)Deborah K. Ross (Democratic)Juan Ciscomani (Republican)Suzanne Bonamici (Democratic)Josh Gottheimer (Democratic)Nanette Diaz Barragán (Democratic)Nick LaLota (Republican)Mike Levin (Democratic)

Ways and Means Committee, Energy and Commerce Committee

  • Introduced
  • In Committee
  • On Floor
  • Passed Chamber
  • Enacted
The "HELP Copays Act" aims to reduce patient out-of-pocket costs by requiring health insurance plans to count financial assistance towards deductibles, coinsurance, copayments, and out-of-pocket limits. This includes assistance provided by non-profit organizations and prescription drug manufacturers , ensuring these amounts directly benefit the patient's financial responsibility. The bill amends the Public Health Service Act and the Patient Protection and Affordable Care Act to standardize this practice across various health insurance coverages. A significant provision creates a safe harbor for High Deductible Health Plans (HDHPs), allowing them to count financial assistance for outpatient prescription drugs towards the minimum deductible without losing their HDHP status, effective for plan years beginning after December 31, 2025. These changes specifically apply to specialty drugs and those subject to utilization management, but explicitly state they will not impact the use of existing utilization management tools like prior authorization or step therapy. The overall goal is to ensure that third-party financial support directly contributes to a patient's satisfaction of cost-sharing requirements.
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Timeline

Bill from Previous Congress

HR 117-5801
HELP Copays Act

Bill from Previous Congress

HR 118-830
HELP Copays Act
Mar 5, 2025

Latest Companion Bill Action

S 119-864
Introduced in Senate
Dec 4, 2025
Introduced in House
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.
  • Bill from Previous Congress

    HR 117-5801
    HELP Copays Act


  • Bill from Previous Congress

    HR 118-830
    HELP Copays Act


  • March 5, 2025

    Latest Companion Bill Action

    S 119-864
    Introduced in Senate


  • December 4, 2025
    Introduced in House


  • December 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.

Health

Related Bills

  • S 119-864: HELP Copays Act

HELP Copays Act

USA119th CongressHR-6423| House 
| Updated: 12/4/2025
The "HELP Copays Act" aims to reduce patient out-of-pocket costs by requiring health insurance plans to count financial assistance towards deductibles, coinsurance, copayments, and out-of-pocket limits. This includes assistance provided by non-profit organizations and prescription drug manufacturers , ensuring these amounts directly benefit the patient's financial responsibility. The bill amends the Public Health Service Act and the Patient Protection and Affordable Care Act to standardize this practice across various health insurance coverages. A significant provision creates a safe harbor for High Deductible Health Plans (HDHPs), allowing them to count financial assistance for outpatient prescription drugs towards the minimum deductible without losing their HDHP status, effective for plan years beginning after December 31, 2025. These changes specifically apply to specialty drugs and those subject to utilization management, but explicitly state they will not impact the use of existing utilization management tools like prior authorization or step therapy. The overall goal is to ensure that third-party financial support directly contributes to a patient's satisfaction of cost-sharing requirements.
View Full Text

Suggested Questions

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

Timeline

Bill from Previous Congress

HR 117-5801
HELP Copays Act

Bill from Previous Congress

HR 118-830
HELP Copays Act
Mar 5, 2025

Latest Companion Bill Action

S 119-864
Introduced in Senate
Dec 4, 2025
Introduced in House
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.
  • Bill from Previous Congress

    HR 117-5801
    HELP Copays Act


  • Bill from Previous Congress

    HR 118-830
    HELP Copays Act


  • March 5, 2025

    Latest Companion Bill Action

    S 119-864
    Introduced in Senate


  • December 4, 2025
    Introduced in House


  • December 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.
Thomas H. Kean

Thomas H. Kean

Republican Representative

New Jersey

Cosponsors (28)
Mark Pocan (Democratic)Ed Case (Democratic)Mariannette Miller-Meeks (Republican)Jimmy Panetta (Democratic)Steve Cohen (Democratic)Thomas R. Suozzi (Democratic)Haley M. Stevens (Democratic)Jake Auchincloss (Democratic)Ted Lieu (Democratic)Maria Elvira Salazar (Republican)Daniel Meuser (Republican)Joe Wilson (Republican)Doris O. Matsui (Democratic)Suhas Subramanyam (Democratic)Daniel S. Goldman (Democratic)Sharice Davids (Democratic)August Pfluger (Republican)Bonnie Watson Coleman (Democratic)Lateefah Simon (Democratic)Mike Quigley (Democratic)Brian K. Fitzpatrick (Republican)Deborah K. Ross (Democratic)Juan Ciscomani (Republican)Suzanne Bonamici (Democratic)Josh Gottheimer (Democratic)Nanette Diaz Barragán (Democratic)Nick LaLota (Republican)Mike Levin (Democratic)

Ways and Means Committee, Energy and Commerce Committee

Health

Related Bills

  • S 119-864: HELP Copays Act
  • Introduced
  • In Committee
  • On Floor
  • Passed Chamber
  • Enacted