HELP Copays Act

Section 2(a): This section amends the Public Health Service Act to require that standards for deductibles, coinsurance, copayments, and out-of-pocket limits include amounts paid by or on behalf of an individual. This is beneficial because it means financial assistance from non-profit organizations and prescription drug manufacturers will count toward these cost-sharing limits.

Section 2(b)(1): This section amends the Patient Protection and Affordable Care Act to ensure that charges and expenditures include financial assistance paid by or on behalf of an individual. This helps people by ensuring that financial assistance from non-profit organizations and prescription drug manufacturers counts toward deductibles, co-insurance, co-payments, and other charges.

Section 2(b)(3): This section amends the Internal Revenue Code of 1986 to create a safe harbor for high deductible health plans starting after December 31, 2025. This is a positive outcome because a plan will not lose its status as a high deductible health plan when it counts financial assistance from non-profits and drug manufacturers for outpatient prescription drugs toward the minimum deductible.