Bill · H.R. 5139· House(119-HR-5139)
EPIPEN Act
- Introduced
- 9/4/2025
- Last activity
- 9/4/2025 — Referred to the Committee on Energy and Commerce, and in addition to the Committees on Education and Workforce, and Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
- Sponsored by
- Maxwell Frost
- Cosponsors
- - 1 - 0
- Introduced
- In Committee
What this bill would do
The "EPIPEN Act" sets rules for how group and individual health insurance plans handle costs for epinephrine delivery systems. It prohibits these plans from applying deductibles to these systems and limits cost sharing to no more than $60 per package of two delivery systems. Any payments made toward this cost sharing must count toward a person's deductible or out-of-pocket maximum. These rules apply to FDA-approved delivery systems, including nasal sprays and auto-injectors. The changes would take effect for plan years starting on or after January 1, 2026.
Yes· 3 of 31
Would households on low incomes be better off under this?+9
Removing deductibles and capping costs is most impactful for those with limited financial resources.
Would children be better off under this?+8
Children with severe allergies often require epinephrine, and this reduces costs for families.
Does this lower the price of prescription medicines?+8
Caps out-of-pocket costs for epinephrine delivery systems at $60 per package.
The opposite
Would business owners be better off under this?-2
Employer-sponsored group health plans may see an increase in claims costs.
Does this lower what people pay for private health insurance?-2
Mandating lower cost sharing may lead insurers to marginally increase premiums to offset costs.
Does this leave more decisions to the states?-2
Imposes federal restrictions on how insurance plans operate, limiting state-level flexibility.
Who it would affect, and how
Potential Positive Impacts for People
-
Lower Out-of-Pocket Costs: Health plans cannot apply deductibles and cannot charge more than $60 for a package of two delivery systems, which lowers the cost for people needing epinephrine (Sec. 2(a), 2(b)(a), 2(c)(a)).
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Credit Toward Maximums: Payments made for these delivery systems count toward a person's deductible or out-of-pocket maximum (Sec. 2(a)(b), 2(b)(b), 2(c)(b)).
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Broad Coverage: The rules apply to various FDA-approved methods of delivering epinephrine, such as sublingual systems, nasal sprays, and auto-injectors (Sec. 2(a)(d), 2(b)(d), 2(c)(d)).
Potential Negative Impacts for People
- Out-of-Network Costs: The bill does not require plans to provide benefits for delivery systems from out-of-network providers, and it allows plans to charge higher cost sharing for those providers (Sec. 2(a)(c), 2(b)(c), 2(c)(c)).
Groups and Interests Ranking
Every group the model scored this bill for, from -10 to +10. Hover a score for the reason it gave.
- Demographic And Interest Groups
- Good For Low Income Households+9Good For Children+8Good For Middle Class Households+7Good For Middle Aged+6Good For Retirees+6Good For Seniors+6Good For Students+6Good For Young Adults+6Good For African Americans+5Good For Asian Americans+5Good For Hispanic Americans+5Good For Immigrants+5Good For L G B T Q Community+5Good For Men+5Good For Native Americans+5Good For People With Disabilities+5Good For Rural Residents+5Good For Union Workers+5Good For Urban Residents+5Good For Veterans+5Good For White Americans+5Good For Women+5Good For Billionaires+4Good For High Income Households+4Good For High Net Worth Individuals+4Good For Ultra High Net Worth Individuals+4Good For Business Owners-2
- Healthcare
- Reduces Prescription Drug Costs+8Improves Healthcare Access+7Reduces Private Insurance Premiums-2
- Economy And Finance
- Improves Consumer Protection+5
- Social Issues And Justice
- Improves Poverty Reduction+3
- Governance And Ideology
- Increases Federal Power+2Increase States Rights-2
- 9/4/2025
- Referred to the Committee on Energy and Commerce, and in addition to the Committees on Education and Workforce, and Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
- 1 Cosponsor added.
- Introduced in House
Doris MatsuiDemocrat · California