Drug makers get green light to fund your copays—and raise prices
H.R. 6423 — HELP Copays Act · Filed by Thomas Kean (R-NJ) · 62 cosponsors · Introduced Dec 4, 2025 · Referred to committee
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What it does
This bill allows financial assistance from nonprofits and drug manufacturers to count toward patients' deductibles, copayments, and out-of-pocket limits under health insurance plans. Starting in 2026, when a patient receives copay assistance (e.g., a manufacturer pays $100 of a $150 copay), that $100 now counts as if the patient paid it themselves, reducing their remaining out-of-pocket obligation. The bill also protects high-deductible health plans from losing tax-advantaged status when they accept manufacturer copay assistance.
Why we flagged it
The bill's operative mechanism is to legitimize and incentivize manufacturer-funded copay assistance by making it count toward cost-sharing thresholds. While framed as patient relief, the primary beneficiary is the pharmaceutical industry, which gains a regulatory safe harbor to use copay programs as a pricing and market-capture tool without triggering high-deductible plan disqualification.
What the text implies
- Copay assistance funded by manufacturers becomes a de facto price subsidy that obscures true drug costs from patients and insurers, potentially enabling higher list prices without visible consumer resistance.
- High-deductible health plan (HDHP) safe harbor removes a regulatory brake on manufacturer copay programs; previously, excessive copay assistance could disqualify a plan from HDHP tax treatment. This amendment eliminates that constraint.
The full analysis lists 5 implications of this text.
Who stands to gain
pharmaceutical manufacturers; specialty drug companies; health insurers (short-term cost transfer)