Sponsor
Frank Pallone
Representative · D-NJ
Representative · D-NJ
Official title: To provide for lower costs for everyday Americans, and for other purposes.
Introduced March 3, 2025 by Frank Pallone · Last progress March 3, 2025
The bill increases transparency, access to telehealth and home-based care, and public-health preparedness while pushing many actors—states, providers, PBMs, plans, pharmacies, and small businesses—to absorb substantial new reporting, compliance, and administrative costs and raises privacy and budgetary tradeoffs.
Millions of patients, plan participants, and employers get much clearer, machine-readable PBM and drug-pricing data so plans can audit rebates, detect conflicts, and potentially negotiate lower premiums or out-of-pocket costs.
Medicare, Medicaid enrollees, rural patients, and children gain expanded access to care through extended telehealth flexibilities, cross-state Medicaid provider enrollment for children, extended Acute Hospital Care at Home waivers, and expanded home-infusion Part B coverage.
Hospitals, public health officials, and communities get substantially increased funding, planning, and infrastructure for medical countermeasures, regional biocontainment labs, testing preparedness, surveillance, and surge capacity to strengthen emergency preparedness and response.
State and local governments, health systems, PBMs, plans, pharmacies, and many private entities face large new, recurring reporting and compliance burdens that will require staff time, IT changes, and ongoing administrative costs.
Taxpayers and federal budgets absorb substantial new appropriations and program costs (multiple multi‑million and multi‑hundred‑million authorizations), creating tradeoffs with other spending priorities and potential future budget pressures (including a mandated FY2033 sequestration ordering).
Extensive claims-level and machine-readable data reporting raises patient privacy and data‑security risks if de‑identification or HIPAA/HITECH safeguards fail or business associates mishandle sensitive health information.
Based on analysis of 37 sections of legislative text.
Requires PBM and plan drug-price transparency reports, bans high‑sodium‑nitrite consumer products, reforms Medicaid/Medicare rules, boosts public-health preparedness, and creates NTIA/blockchain governance changes.
Makes wide-ranging changes to lower health care and consumer costs, increase transparency in drug pricing and pharmacy benefit manager (PBM) contracts, strengthen consumer product safety rules, modernize telecommunications and NTIA leadership, and boost public-health preparedness and recycling reporting. It requires new reporting and disclosure by PBMs and health plans, limits certain patent assertions for biosimilars, expands Medicaid and Medicare program rules, mandates safety standards and a hazardous-product ban, creates blockchain advisory functions at Commerce, and funds/reshapes several public-health preparedness activities.