Health care costs

Prescription Drug Price Relief Act of 2025

This bill requires the Department of Health and Human Services (HHS) to review brand-name drugs annually for excessive pricing and, if a drug is found to be priced excessively, to void any exclusivity granted to its sponsor.

Specifically, HHS must review all brand-name drug prices at least annually and upon petition. If any such drugs are found to be excessively priced, HHS must (1) void any government-granted exclusivity; (2) issue open, nonexclusive licenses for the drugs; and (3) expedite the review of corresponding applications for generic drugs and biosimilar biological products. HHS must also create a public database with its determinations for each drug.

An entity accepting an open, nonexclusive license under these provisions must pay a reasonable royalty to the holder of the relevant patent or approved new drug application, and must price the generic drug or biosimilar below the excessive rate.

Under the bill, a price is considered excessive if the domestic average manufacturing price exceeds the median price for the drug in Canada, the United Kingdom, Germany, France, and Japan. If a price does not meet this criteria, or if pricing information is unavailable in at least three of these countries, the price is still considered excessive if it is higher than reasonable in light of specified factors, including development cost, revenue, and the size of the affected patient population.

The bill also requires drug manufacturers to report specified financial information for brand-name drugs, including research and advertising expenditures.

Abortion Is Not Health Care Act of 2025

This bill excludes amounts paid for an abortion from the itemized tax deduction for qualified medical and dental expenses.

Under current law, individuals who itemize their tax deductions may deduct qualified medical and dental expenses to the extent that such expenses exceed 7.5% of the individual’s adjusted gross income for the tax year. Further, under current law, the calculation of the itemized tax deduction for medical and dental expenses may include amounts paid for a legal abortion.

Modern Authentication of Pharmaceuticals Act of 2025

This bill requires each dose of a pharmaceutical product that is a controlled substance and that is taken orally in solid form (i.e., pills) to include a physical chemical identifier. (Physical chemical identifiers are substances that possess a unique physical or chemical property, such as inks, pigments, flavors, and molecular taggants, that unequivocally identify and authenticate a drug or dosage.) Under the bill, physical chemical identifiers must be included in or on the product and must be machine readable.

The bill applies to products manufactured beginning five years after the bill's enactment.

Veterans' True Choice Act of 2025

This bill allows covered veterans to receive coverage under TRICARE Select, a health care program of the Department of Defense (DOD). Veterans covered by this bill include those with service-connected disabilities, former prisoners of war, Purple Heart recipients, Medal of Honor recipients, those discharged from service due to disability, and those entitled to disability compensation.

The Department of Veterans Affairs (VA) must reimburse DOD's costs of enrolling eligible veteran beneficiaries in the program.

A covered veteran may not concurrently receive medical care from DOD and the VA.

Prescription Drug Transparency and Affordability Act

This bill requires pharmacy benefit managers (PBMs) to report, at least once every six months, prescription drug pricing, payment, and utilization data to the health insurance plans for which the PBM provides services.

Specifically, a PBM contracted to provide services to an employer or sponsor offering a large group health insurance plan (i.e., a plan with at least 100 employees or participants) must report to the plan certain information for prescription drug claims under the plan. This includes, for each drug, the difference between the compensation paid by the plan to the PBM and the compensation paid by the PBM to the pharmacy.

Further, for each therapeutic class of drugs under the plan, a PBM must report (1) the total amount it received in rebates, fees, and discounts; and (2) the net spending for each class after such rebates, fees, and discounts.

Each PBM also must report certain information about (1) drugs for which total spending exceeded $10,000; and (2) drugs dispensed through pharmacies affiliated with the plan or PBM, such as the percentage of prescriptions dispensed by such affiliates.

Finally, a PBM providing services to any group health insurance plan must provide the plan with a summary document that includes similar information for prescription drug claims under the plan, as determined by the Department of Health and Human Services. Plans must also make certain aggregate summary information available to plan participants.

PBMs and plans that violate these requirements are subject to civil penalties.

Maximizing Israel-U.S. Research Advancement and Collaborative Leadership in Emerging Medical Technology Act of 2025 or the MIRACLE Medical Technology Act of 2025

This bill requires the Department of Health and Human Services (HHS) to implement a program for the United States and Israel to collaborate on developing and delivering health care products and services. The program must include coordinated activities in specified areas, including research and development, use of innovative technology, intellectual property protection, regulatory harmonization, disease prevention, and biological product manufacturing. The bill authorizes HHS to establish a joint United States-Israel Health Care Collaboration Center in the United States to leverage existing expertise for advancing the program’s purposes.

Veterans Access to Direct Primary Care Act

This bill requires the Department of Veterans Affairs (VA) to implement a five-year pilot program to provide veterans who are enrolled in the VA health care system with the option to receive primary care services from a non-VA health care provider under a direct primary care service arrangement and pay using a veteran health savings account.

Medically Tailored Home-Delivered Meals Program Pilot Act

This bill requires the Centers for Medicare & Medicaid Services (CMS) to establish a temporary program through which certain Medicare beneficiaries with diet-impacted diseases may receive medically tailored meals at home to reduce their rate of hospital readmissions.

Specifically, the CMS must select, upon application, at least 40 hospitals to participate in a six-year program to deliver medically tailored meals to qualifying individuals' homes. Participating hospitals must meet specified program integrity and quality of care metrics and certify that they are able to provide the required meals and associated medical nutrition therapy. Hospitals must have a physician, registered dietitian or nutrition professional, advanced practice nurse, or clinical social worker screen inpatients upon discharge from the hospital and every 12 weeks thereafter to determine whether these individuals qualify for the meal program.

In order to qualify for the program, individuals must have a diet-impacted disease (e.g., kidney disease), live at home, not be receiving extended care services or hospice care, be limited with respect to at least two activities of daily living, and meet any other criteria for high-risk readmissions (as determined by the CMS).

Preventive Health Savings Act

This bill requires the Congressional Budget Office (CBO), upon receiving a request from Congress, to determine if proposed legislation would reduce spending outside of the 10-year budget window through the use of preventive health care.

Under the bill, the term preventive health care generally refers to an action that focuses on the health of the public, individuals, and defined populations in order to protect, promote, and maintain health and wellness and prevent disease, disability, and premature death.

If CBO determines that the proposed legislation would result in net reductions in budget outlays from the use of preventive health care, any CBO projection regarding the legislation must include (1) a description and estimate of the reductions in outlays, and (2) a description of the basis for these conclusions.

Any estimate provided by CBO pursuant to this bill must be used as a supplementary estimate and may not be used to determine compliance with the Congressional Budget Act of 1974 or any other budgetary enforcement controls.

Preserving Life-saving Access to Specialty Medicines in America Act or the PLASMA Act

This bill phases-in certain price adjustments for plasma-derived products under the Medicare prescription drug benefit's Manufacturer Discount Program.

Current law requires manufacturers of covered drugs under the Medicare prescription drug benefit to provide a 10% discount for covered drugs during the initial coverage phase (i.e., before a beneficiary reaches the out-of-pocket spending threshold) and a 20% discount during the catastrophic coverage phase (i.e., after a beneficiary reaches the out-of-pocket spending threshold).

The bill phases-in discounts for plasma-derived products over several years, starting with a 1% discount in 2026 for both the initial and catastrophic coverage phases, and ending with a 10% discount beginning in 2030 for the initial coverage phase and a 20% discount beginning in 2032 for the catastrophic coverage phase.

Responsible Path to Full Obamacare Repeal Act

This bill repeals the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010, effective at the beginning of FY2026. Provisions of law amended by those acts are restored.

Medicare IVIG Access Enhancement Act of 2025

This bill provides for Medicare coverage of in-home administration of intravenous immune globulin to treat chronic inflammatory demyelinating polyneuropathy (CIDP) or multifocal motor neuropathy. (CIDP is an autoimmune condition that causes symptoms such as muscle weakness and numbness; multifocal motor neuropathy is a variant of CIDP that only causes asymmetric muscle weakness.)

Reducing Drug Prices for Seniors Act

This bill requires the coinsurance amount for covered drugs under the Medicare prescription drug benefit to be based on the actual acquisition cost of the drug (i.e., the negotiated price under the prescription drug plan net of any manufacturer price concessions), rather than the wholesale acquisition cost of the drug, if the actual acquisition cost is lower.

Mapping America’s Pharmaceutical Supply Act or the MAPS Act

This bill requires the Food and Drug Administration (FDA) to continually update its essential medicines list and identify risks and vulnerabilities in the associated supply chains.

In 2020, in response to an executive order, the FDA published a list of essential medicines deemed medically necessary to have available at all times. The bill requires the FDA to update and maintain this list to include drugs and ingredients (1) related to responding to public health threats and emergency incidents, (2) that are of greatest priority for providing health care and are at high risk of shortage, and (3) the shortage of which would adversely affect patients with chronic conditions. The FDA must review the list at least every two years and update it as appropriate.

Also, the bill requires the FDA to conduct a risk assessment of the supply chains for drugs and ingredients on the list and annually report its findings to Congress. The assessment must include information about key manufacturing materials, drugs with primarily foreign or single suppliers, manufacturing capacity, relevant public health and national security risks, and risk mitigation strategies.

Additionally, the Department of Health and Human Services (HHS) must map and monitor relevant supply chains to identify vulnerabilities and provide an annual status report to Congress. HHS must facilitate the secure exchange of information among agencies regarding locations and quantities of production and relevant regulatory actions.

Save our Lone Emergency Services Act or the SOLES Act

This bill requires Medicare payments to sole community hospitals in Alaska or Hawaii to cover at least 94% of the reasonable costs of covered outpatient services.

Ensuring Outpatient Quality for Rural States Act

This bill allows Medicare payments for covered hospital outpatient services in Alaska or Hawaii to include certain cost-of-living adjustments.