The "Affordable Inhalers and Nebulizers Act of 2025" aims to significantly reduce the financial burden on patients for prescription inhaler products and associated equipment used to manage breathing disorders such as asthma and chronic obstructive pulmonary disease (COPD). This legislation amends key federal acts, including the Public Health Service Act, the Internal Revenue Code, the Employee Retirement Income Security Act, and the Social Security Act, to implement these cost-sharing reductions across various health coverage types. Its primary goal is to ensure greater affordability and access to essential respiratory medications and devices. For individuals with private health insurance, the bill mandates that group health plans and health insurance issuers must cover all specified inhaler products , which include maintenance, reliever, and rescue inhalation drugs, as well as equipment like nebulizers and spacers. These plans will be prohibited from applying any deductible to these products and may not impose cost-sharing exceeding $15 per 30-day supply . Any incurred cost-sharing must also count towards a participant's out-of-pocket maximum and deductible, with special provisions ensuring high-deductible and catastrophic plans remain compliant, effective for plan years beginning on or after January 1, 2026. For Medicare beneficiaries, the bill eliminates deductibles for specified inhaler products under both Medicare Part B and Part D , capping cost-sharing at $15 per 30-day supply for all beneficiaries, including low-income individuals, starting January 1, 2026. Additionally, it establishes a "Specified Inhaler Product Payment Program" for uninsured individuals. Under this program, the Secretary of Health and Human Services will reimburse registered providers, ensuring uninsured patients pay no more than $15 for a month's supply of these critical medications and equipment.
The "Affordable Inhalers and Nebulizers Act of 2025" aims to significantly reduce the financial burden on patients for prescription inhaler products and associated equipment used to manage breathing disorders such as asthma and chronic obstructive pulmonary disease (COPD). This legislation amends key federal acts, including the Public Health Service Act, the Internal Revenue Code, the Employee Retirement Income Security Act, and the Social Security Act, to implement these cost-sharing reductions across various health coverage types. Its primary goal is to ensure greater affordability and access to essential respiratory medications and devices. For individuals with private health insurance, the bill mandates that group health plans and health insurance issuers must cover all specified inhaler products , which include maintenance, reliever, and rescue inhalation drugs, as well as equipment like nebulizers and spacers. These plans will be prohibited from applying any deductible to these products and may not impose cost-sharing exceeding $15 per 30-day supply . Any incurred cost-sharing must also count towards a participant's out-of-pocket maximum and deductible, with special provisions ensuring high-deductible and catastrophic plans remain compliant, effective for plan years beginning on or after January 1, 2026. For Medicare beneficiaries, the bill eliminates deductibles for specified inhaler products under both Medicare Part B and Part D , capping cost-sharing at $15 per 30-day supply for all beneficiaries, including low-income individuals, starting January 1, 2026. Additionally, it establishes a "Specified Inhaler Product Payment Program" for uninsured individuals. Under this program, the Secretary of Health and Human Services will reimburse registered providers, ensuring uninsured patients pay no more than $15 for a month's supply of these critical medications and equipment.