Healthcare (Prescription Drugs)

in committee · United States · House Mar 18, 2025

HR 2214: DRUG Act

This bill prohibits pharmacy benefit managers (PBMs) from receiving payments tied to prescription drug prices or rebates starting January 1, 2027. Instead, PBMs may only charge flat, itemized fees for actual services performed (e.g., claim processing), not based on drug costs or discounts. It directly affects PBMs and health insurance plans by requiring compensation to be decoupled from drug pricing, while allowing rebates to be passed through to lower net drug costs. The law aims to reduce conflicts of interest in PBM operations without changing drug pricing itself.

Topics ✓ HealthcareSupports HealthcareDecouples PBM fees from drug prices, requiring flat service fees. Aims to reduce net drug costs and improve patient access to medications by eliminating rebate-based compensation structures.92% confidence

Sub-Topics Insurance Prescription Drugs

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in committee · United States · House May 20, 2026

HR 6580: VA National Formulary Act of 2025

The VA National Formulary Act of 2025 creates a single, uniform list of drugs available at all VA medical facilities, replacing any local drug lists. It establishes a Pharmacy and Therapeutics Committee to make evidence-based decisions on drug inclusion (reviewing new FDA-approved drugs within 120 days) and sets up a 96-hour timeline for processing veterans' requests for nonformulary drugs. The VA must report annual formulary changes to Congress and implement a tiered copayment system that lowers costs for formulary drugs. The bill also includes provisions for negotiating drug discounts and value-based agreements to achieve cost savings.

Topics ✓ HealthcareSupports HealthcareCreates uniform VA drug formulary with evidence-based decisions and faster processing for nonformulary drugs, improving veterans' medication access and system consistency.95% confidence ✓ VeteransSupports VeteransCreates uniform drug access, 120-day FDA review, 96-hour nonformulary processing - directly improves VA healthcare access and consistency for veterans.95% confidence

Sub-Topics Prescription Drugs Veteran Benefits Veteran Education Veteran Healthcare

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in committee · United States · House Dec 3, 2025

HR 6400: Rx ACCESS Act

The Rx ACCESS Act improves prescription drug access for TRICARE beneficiaries, including military service members, retirees, and their families, by establishing fair reimbursement standards for pharmacies and expanding medication choice. It requires pharmacies to be reimbursed at actual drug costs (or the national average drug cost for certain medications) plus a standard dispensing fee, while banning hidden fees like point-of-sale charges. Starting October 1, 2026, beneficiaries can choose how they receive non-generic medications for ongoing health conditions. The law also mandates annual audits to verify reimbursement fairness and ensure pharmacy networks provide accessible care, especially in rural and underserved areas.

Topics ✓ HealthcareSupports HealthcareExpands prescription drug access for military beneficiaries by mandating fair pharmacy reimbursement and banning hidden fees, improving affordability and choice in medication coverage.95% confidence ✓ VeteransSupports VeteransBill improves TRICARE prescription drug access for veterans (retirees/families), expanding healthcare benefits by banning hidden fees and ensuring fair reimbursement.95% confidence

Sub-Topics Prescription Drugs

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in committee · United States · House Mar 11, 2025

HR 2041: Hidden Fee Disclosure Act of 2025

The Hidden Fee Disclosure Act of 2025 requires pharmacy benefit managers and third-party administrators providing services to employee benefit plans to disclose detailed information about their compensation structures. Covered service providers must annually report all fees, rebates, discounts, and other financial arrangements they receive, including how much is retained versus passed through to the plan. This includes specific details about spread pricing, rebate handling, and compensation from drug manufacturers. The bill applies to all contracts entered into on or after January 1, 2026, and aims to increase transparency for plan fiduciaries managing employee health benefits.

Topics ✓ HealthcareSupports HealthcareRequires transparency in pharmacy benefit manager fees, protecting patients from hidden costs and improving cost clarity in healthcare financing.85% confidence ✓ Labor & EmploymentSupports Labor & EmploymentRequires transparency in pharmacy benefit manager fees for employee health plans, preventing hidden costs that could reduce benefit value for workers.85% confidence

Sub-Topics Prescription Drugs

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passed · United States · House Dec 18, 2025

HR 6703: Lower Health Care Premiums for All Americans Act

The Lower Health Care Premiums for All Americans Act (HR 6703) requires large health plans (with at least 100 average participants) and pharmacy benefit managers to submit detailed reports every six months on drug spending, rebates, and out-of-pocket costs. These reports include specific information on drug costs, rebates received, pricing structures, and spending patterns, making this information available to plan sponsors and participants. The bill also establishes new rules for association health plans and health reimbursement arrangements to expand affordable coverage options for workers and self-employed individuals. The primary goal of these reporting requirements is to increase transparency around health care costs, allowing consumers and employers to make more informed decisions about health coverage. The bill does not directly set or reduce premiums but provides data that could inform future premium negotiations and decisions.

Topics ✓ HealthcareSupports HealthcareRequires transparency in drug pricing/rebates to lower premiums, improving cost access for patients.85% confidence

Sub-Topics Insurance Prescription Drugs

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in committee · United States · House Nov 19, 2025

HR 6157: FORCE Act of 2025

The FORCE Act of 2025 allows eligible first responders to enroll in Medicare at age 57 instead of the standard 65. To qualify, individuals must be between 57 and 64 years old, have worked 10+ years in specific first responder occupations (identified by Bureau of Labor Statistics codes like 33-1010 or 33-2000), and not yet qualify for standard Medicare at age 65. The bill establishes a new Medicare benefit section with premiums based on standard Part B/A costs, funded through a dedicated "Medicare First Responder Trust Fund." It ensures these enrollees receive full Medicare benefits, including prescription drug coverage, without affecting existing Medicare or Medicaid eligibility.

Topics ✓ HealthcareSupports HealthcareExpands Medicare eligibility for first responders to age 57, providing earlier health insurance coverage. Directly advances healthcare access for a specific group through expanded coverage.90% confidence ✓ Labor & EmploymentSupports Labor & EmploymentExpands Medicare access for first responders (specific worker group), providing earlier healthcare benefits which aligns with expanding worker benefits.85% confidence

Sub-Topics Medicaid Medicare Prescription Drugs

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in committee · United States · House Jul 10, 2025

HR 4317: PBM Reform Act of 2025

The PBM Reform Act of 2025 aims to increase transparency and fairness in pharmacy benefit manager (PBM) operations within Medicare Part D and Medicaid programs. The bill requires Medicare Part D plans to allow any pharmacy meeting standard terms to join their networks, establishes "essential retail pharmacies" in underserved areas (with limited pharmacy access), and mandates detailed reporting on drug pricing, rebates, and reimbursement rates. It creates a process for pharmacies to report PBM violations of reasonable contract terms and prohibits "spread pricing" in Medicaid, where PBMs retain the difference between what they pay pharmacies and what they charge plans. These provisions aim to improve pharmacy access for Medicare beneficiaries and ensure fairer reimbursement practices for pharmacies.

Topics ✓ HealthcareSupports HealthcareIncreases transparency in PBMs, mandates fair pharmacy access in underserved areas, and requires detailed pricing reports to improve patient access and reduce costs in Medicare/Medicaid programs.90% confidence

Sub-Topics Medicaid Medicare Prescription Drugs

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in committee · United States · House May 13, 2025

HR 3375: Fair Prescription Drug Prices for Americans Act

HR 3375, the Fair Prescription Drug Prices for Americans Act, sets a cap on the U.S. list price for prescription drugs and biological products, limiting it to the average price charged in Canada, France, Germany, Italy, Japan, and the United Kingdom. Drug manufacturers must annually report U.S. and international list prices to the Health and Human Services Secretary, who calculates the average price for each drug. Manufacturers violating the price cap face civil penalties equal to 10 times the price difference per unit sold in the U.S. The bill directly affects drug manufacturers by restricting U.S. pricing and imposing financial penalties for noncompliance.

Topics ✓ HealthcareSupports HealthcareCaps U.S. drug prices at international averages, directly improving patient access and affordability in healthcare.95% confidence

Sub-Topics Prescription Drugs

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in committee · United States · House May 14, 2026

HR 6652: U.S. Vets of the FAS Act

HR 6652, the "U.S. Vets of the FAS Act," requires the Department of Veterans Affairs (VA) to provide telehealth services and mail-order pharmacy deliveries to veterans residing in the Freely Associated States (FAS) - which include the Marshall Islands, Micronesia, and Palau. The bill mandates the VA to establish agreements with FAS governments within one year of enactment and begin offering these services within the same timeframe. It also modifies travel payment rules to require VA to cover beneficiary travel costs starting one year after enactment. The VA must report quarterly on implementation progress and costs to Congress until agreements are finalized and services launched. This bill directly affects veterans in FAS territories and VA operations related to their healthcare access.

Topics ✓ HealthcareSupports HealthcareBill mandates VA telehealth services and mail-order pharmacy for FAS veterans, directly expanding healthcare access and coverage for a specific population.95% confidence ✓ VeteransSupports VeteransMandates VA telehealth and mail-order pharmacy for FAS veterans, expanding healthcare access and benefits per bill's explicit requirements.95% confidence

Sub-Topics Prescription Drugs Telehealth Veteran Benefits Veteran Healthcare Veteran Mental Health

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in committee · United States · House Jan 3, 2025

HR 44: Rural 340B Access Act of 2025

HR 44, the Rural 340B Access Act of 2025, would expand eligibility for the federal 340B drug discount program to include specific rural emergency hospitals. It directly affects rural emergency hospitals owned or operated by state/local governments, non-profits with governmental powers, or private non-profits with contracts to serve low-income patients. The bill amends the law to formally add these hospitals as "covered entities" under the 340B program, allowing them to purchase discounted drugs. This change would enable these facilities to access the same drug discounts previously available to other safety-net providers.

Topics ✓ HealthcareSupports HealthcareExpands 340B program eligibility to rural emergency hospitals, improving access to discounted drugs for low-income patients through expanded coverage.95% confidence

Sub-Topics Hospitals Medicaid Prescription Drugs Tags Rural Communities

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