The Medication Competition Act requires the Food and Drug Administration to publish specific expiration dates for legal protections on biological drugs. This rule applies to both new drugs approved after the law passes and older drugs that received protection before the law was enacted. By making these timelines public, the bill aims to help generic drug makers know exactly when they can start selling their own versions of these medicines. The change does not alter the length of the protection periods themselves but increases transparency regarding when those periods end.
The MISSION Rx Act ensures that military beneficiaries and veterans pay no more for specific negotiated drugs than Medicare Part D beneficiaries do. It achieves this by capping the out-of-pocket costs for TRICARE-covered servicemembers and copayments for veterans at the same levels established under the federal drug price negotiation program. Additionally, the bill requires federal agencies to limit the maximum prices they agree to pay pharmaceutical manufacturers for these same negotiated drugs. These changes apply to existing contracts and new agreements involving drugs selected for federal price negotiation.
The Next GEN Act of 2026 modifies the Drug Price Negotiation Program to include a specific category of medications called engineered cyclic peptides. This change extends the time before these drugs can be negotiated for lower prices from seven years to eleven years. The bill defines these peptides as synthetic, amino acid-based drugs that are self-administered and created using genetic library screening methods. By adjusting the timeline, the legislation directly affects pharmaceutical companies and the government agencies responsible for setting drug prices under the program.
The Patients Before Monopolies Act aims to break up large health care companies that currently own both insurance or pharmacy benefit management services and physical pharmacies. It directly affects major health care conglomerates by making it illegal for them to own pharmacies while also managing drug pricing or insurance, requiring them to sell off their pharmacy operations within one year. The bill empowers federal agencies like the FTC and the Department of Justice to enforce these rules, impose financial penalties for non-compliance, and block future mergers that would recreate these conflicts of interest.
The Drug Deal Disclosure Act requires the Department of Health and Human Services to publicly release specific records regarding agreements between the federal government and major drug manufacturers starting in 2025. This law mandates the disclosure of contracts that include provisions such as reduced drug prices based on international rates, direct-to-consumer sales discounts, duty exemptions, and special treatment for Medicare programs. While the bill allows for the redaction of confidential pricing details, it prohibits withholding information based on political sensitivity or reputational harm and requires a detailed justification for any redactions. Additionally, the act mandates reports to Congress and independent analysis from the Congressional Budget Office and the Government Accountability Office to evaluate the economic and budgetary impacts of these agreements.
The Affordable Insulin Now Act of 2026 mandates that private health plans, including those under Medicare, ERISA, and the Internal Revenue Code, cover specific insulin products starting in 2027 without applying deductibles. For these covered insulins, the law limits patient out-of-pocket costs to the lesser of $35 per 30-day supply or 25% of the negotiated price, while also counting these payments toward annual deductibles and out-of-pocket maximums. The legislation defines "selected insulin products" to include at least one dosage form of each type available, such as rapid-acting or long-acting varieties, but does not require coverage for insulins outside this selection. Additionally, the bill establishes a program to reimburse healthcare providers and pharmacies up to $35 for insulin dispensed to uninsured individuals, ensuring they do not hold the patients liable for the cost.
The Patients Before Monopolies Act prohibits companies from owning both pharmacy benefit managers and insurance businesses or pharmacies to eliminate conflicts of interest. It requires existing violators to sell off their pharmacy operations within one year and grants the Federal Trade Commission and Department of Justice the power to block new mergers that would recreate these combined ownership structures. The bill also allows private citizens and state officials to sue for violations, seeking penalties like disgorgement of profits and treble damages if the law is broken.
This non-binding resolution expresses the House of Representatives' view that the FDA should regulate mifepristone, a medication used for abortion, based on scientific evidence rather than political pressure. It highlights over 25 years of data showing the drug is safe and effective when prescribed via telemedicine or dispensed by mail and pharmacy. The bill advocates for policies that ensure equitable access to this care, particularly for marginalized communities facing barriers due to state-level restrictions. By citing numerous studies and medical organizations, the resolution calls for transparent, science-based decisions to maintain current access methods.
Ensuring Access to Lower-Cost Medicines for Seniors Act This bill requires prescription drug plans under the Medicare prescription drug benefit to include generic drugs and biosimilars on their formularies. Specifically, the bill requires plans that use formularies to include generic drugs and biosimilars on the formularies and without any requirements (e.g., prior authorization requirements) that are more restrictive as compared to those for brand-name drugs and biologics. Plans that use cost-sharing tiers must also have specific tiers for generic drugs and biosimilars, in accordance with certain limitations.
The Every Dollar Counts Act of 2026 requires health insurance plans and issuers to count money spent by individuals on prescription drugs purchased directly, without applying their insurance benefits, towards their annual deductible and out-of-pocket maximums. This means that if an individual pays cash for a drug or uses a discount card instead of their insurance benefits, those expenditures will still contribute to reaching their yearly healthcare spending limits. This change directly affects individuals enrolled in group or individual health insurance coverage. The new rules will take effect for plan years beginning on or after January 1, 2027.
