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Requires private group and individual health plans, ERISA plans, and Medicare Parts B and D to cover defined inhaler drugs and related administration equipment with no deductible and cost-sharing capped at $15 per 30-day supply. Creates a federal payment program for uninsured patients so participating providers accepting program payments cannot bill uninsured people more than $15 per month; gives HHS authority to implement the rules and allows safe-harbor treatment so high-deductible health plans keep HSA compatibility.
The bill makes inhalers far more affordable and accessible for people with chronic respiratory conditions (including Medicare beneficiaries and some uninsured) but shifts some cost risk to private plans/employers, relies on appropriations for uninsured coverage, and raises administrative and HSA‑eligibility questions.
People with asthma or COPD — including Medicare beneficiaries and low-income patients — will pay no deductible and at most $15 per 30-day supply for covered inhaler drugs and related equipment beginning Jan 1, 2026, lowering direct out-of-pocket medication costs.
Uninsured individuals can obtain inhaler products from program-registered providers for no more than $15 per month when HHS makes payments, improving access to essential medications for people without coverage.
Cost-sharing for inhaler products counts toward enrollees' deductibles and out-of-pocket maximums, helping patients reach financial protections sooner and reducing total annual spending for frequent users.
Private health plans and employers may face higher drug spending because of the capped patient cost-sharing, which could be passed on as higher premiums or reduced benefits for workers and families over time.
The $15 cap for uninsured patients depends on HHS payments that are subject to annual appropriations, so uninsured people may not reliably get the lower cost if Congress does not fund the program.
HHS plans to implement details through non-rulemaking guidance, which could reduce transparency, create uncertainty, or delay clear protections for patients and providers while administrative rules are worked out.
Introduced September 10, 2025 by Kweisi Mfume · Last progress September 10, 2025