S.864 - Help Ensure Lower Patient Copays Act; HELP Copays Act (119th Congress)
Summary
S.864, the HELP Copays Act, aims to amend the Public Health Service Act to ensure that financial assistance, including that from non-profit organizations and prescription drug manufacturers, counts towards patients' cost-sharing requirements in health insurance plans. This includes deductibles, coinsurance, and copayments. The bill seeks to make healthcare more affordable by ensuring that all forms of financial assistance reduce the out-of-pocket expenses for patients.
Expected Effects
The bill's passage would lead to lower out-of-pocket healthcare costs for individuals with health insurance, particularly those who rely on financial assistance to afford their medications. It will change how health insurance plans account for financial assistance. This may incentivize more patients to adhere to their prescribed drug regimens, leading to better health outcomes.
Potential Benefits
- Reduced out-of-pocket expenses for patients, making healthcare more affordable.
- Improved medication adherence due to lower costs.
- Greater financial security for individuals with chronic conditions requiring expensive medications.
- Simplification of healthcare financing by standardizing how financial assistance is applied.
- Potential for better health outcomes due to increased access to necessary treatments.
Potential Disadvantages
- Potential for increased premiums if insurance companies pass the cost of covering financial assistance onto consumers.
- Possible unintended consequences related to the negotiation of drug prices and manufacturer incentives.
- Complexity in implementation and administration for health insurance plans.
- Risk of increased utilization of healthcare services, potentially driving up overall healthcare costs.
- May disproportionately benefit individuals with specific conditions or those who are already receiving financial assistance.
Constitutional Alignment
The bill appears to align with the general welfare clause of the US Constitution, as it aims to improve access to healthcare and lower costs for individuals. Specifically, the preamble states the Constitution is intended to "promote the general Welfare." The bill does not appear to infringe upon any specific constitutional rights or limitations. The legislative power to regulate health insurance falls under the powers granted to Congress in Article I, Section 8, which allows Congress to make laws that are necessary and proper for carrying out its enumerated powers.
Impact Assessment: Things You Care About ⓘ
This action has been evaluated across 19 key areas that matter to you. Scores range from 1 (highly disadvantageous) to 5 (highly beneficial).