ACA Copay CAP Act of 2025

H.R. 1 - One Big Beautiful Bill Act - Rep. Arrington, Jodey - Medicaid eligibility and state financing, Marketplace coverage and enrollment, Health Savings Account expansion, Pharmacy Benefit Manager financing and regulation H.R. 90 - Health Coverage Choice Act - Rep. Biggs, Andy - Duration of STLDHI plans H.R. 114 - Responsible Path to Full Obamacare Repeal Act - Rep. Biggs, Andy - ACA repeal H.R. 247 - Health Care Affordability Act - Rep. Underwood, Lauren - ACA tax credit extension H.R. 267 - Health Care Price Transparency Act - Rep. Davidson, Warren - Hospital and insurer transparency requirements H.R. 639 - Doctor Knows Best Act - Rep. Van Drew, Jefferson - Commercial market prior authorization H.R. 957 - Parity Enforcement Act - Rep. Norcross, Donald - Penalties for mental health parity violations H.R. 1385 - DOC Access Act - Rep. Carter, Earl Buddy - Rate setting for dental and optometric services H.R. 1397 - Increasing Access to Dental Insurance Act - Rep. Miller-Meeks, Mariannette - Standalone dental plans H.R. 1776 - New Health Options Act - Rep. Palmer, Gary - ACA reinsurance H.R. 2079 - Insurance Fraud Accountability Act - Rep. Ross, Deborah - fraudulent ACA enrollments H.R. 2199 - Restore Protections for Dialysis Patients Act - Rep. Kelly, Mike - ESRD coverage H.R. 2553 - Capping Prescription Costs Act - Rep. Horsford, Steven - Prescription cost-sharing H.R. 2554 - Lower Drug Costs for Families Act - Rep. Horsford, Steven - Commercial market drug rebates H.R. 2636 - Making Insulin Affordable for All Children Act - Rep. Landsman, Greg - Commercial market insulin cost-sharing H.R. 3020 - Addressing Anti-Competitive Health Care Contract Clauses Act - Rep. Spartz, Victoria - Study on anti-competitive contracting H.R. 3527 - Bridge to Medicaid Act - Rep. Sewell, Terri - ACA subsidies for non-Medicare expansion states H.R. 3701 - Family Vaccine Protection Act - Rep. Pallone, Frank - ACIP codification and vaccine coverage H.R. 4406 - State-Based Universal Health Care Act - Rep. Khanna, Ro - State-based universal health care H.R. 4710 - No Surprises Act Enforcement Act - Rep. Murphy, Greg - Surprise billing penalties for noncompliance by health insurers H.R. 5145 - Bipartisan Premium Tax Credit Extension Act - Rep. Kiggans, Jennifer - Temporary extension of ACA enhanced premium tax credits H.R. 5509 - Safe Step Act - Rep. Allen, Rick - Step therapy requirements H.R. 5582 - Patients Deserve Price Tags Act - Rep. James, John - Hospital and insurer price transparency requirement H.R. 6171 - ACA Copay CAP Act of 2025 - Rep. Auchincloss, Jake - establish out of pocket limit on prescription drugs H.R. 6248 - Healthy Competition for Better Care Act - Rep. Arrington, Jodey - ban anticompetitive terms in contracts, promote higher quality, lower cost care H.R. 6703 - Lower Health Care Premiums for All Americans Act - Rep. Miller-Meeks, Mariannette - amend ERISA to lower premiums H.R. 7023 - Affordable CHOICE Act - Rep. Schakowsky, Janice - public option under ACA H.R. 7164 - Capping Costs for Consumers Act - Rep. Schrier, Kim - ACA cost-sharing reductions H.R. 8270 - Every Dollar Counts Act - Rep. Murphy, Greg - Requirements for deductibles and MOOP to include expenditures for DTC prescriptions H.R. 8684 - Transparency in Billing Act - Rep. Foxx, Virginia - Transparency enforcement H.R. 9393 - Lower Costs, More Transparency Act - Rep. Guthrie, Brett - Healthcare price transparency S. 46 - Health Care Affordability Act - Sen. Shaheen, Jeanne - ACA tax credit extension S. 729 - Hospital Transparency Compliance Enforcement Act - Sen. Kennedy, John - Hospital price transparency requirements S. 864 - HELP Copays Act - Sen. Marshall, Roger - Cost-sharing requirements S. 976 - Insurance Fraud Accountability Act - Sen. Wyden, Ron - fraudulent ACA enrollments S. 2355 - Patients Deserve Price Tags Act - Sen. Marshall, Roger - Hospital and insurer price transparency requirements S. 2420 - No Surprises Act Enforcement Act - Sen. Marshall, Roger - Surprise billing penalties for noncompliance by health insurers S. 2824 - A bill to amend the Internal Revenue Code of 1986 to extend the temporary enhanced premium tax credits - Sen. Murkowski, Lisa - Temporary extension of ACA enhanced premium tax credits S. 2903 - Safe Step Act - Sen. Murkowski, Lisa - Step therapy requirement S. 3599 - Affordable CHOICE Act - Sen. Whitehouse, Sheldon - public option under ACA S. 3990 - PrEP Access and Coverage Act - Sen. Smith, Tina - Coverage requirements for HIV services S. 4189 - INSULIN Act - Sen. Collins, Susan - Insulin cost-sharing caps S. 4512 - Affordable Insulin Now Act - Sen. Kennedy, John - Insulin cost-sharing caps Issues related to implementation rule implementing the No Surprises Act prohibiting surprise medical bills; transparency report requirements; parity in mental health benefits; ERISA preemption; paperless delivery for health plan disclosures; Unauthorized Enrollments/Unauthorized Plan Switching; ACA Tax Credits (Inflation Reduction Act); final rule on Section 1557 of the ACA and its impact on Medigap plans; ACA Marketplace Enrollment and Agents and Brokers; Waste Fraud and Abuse; Vaccine Coverage; Preventative Services Coverage; the Advanced Explanation of Benefits; coverage of weight loss drugs; Transparency in Coverage; No Surprises Act; ACA Marketplace Integrity; ACA Enhanced Tax Credits; Prior Authorization; affordability; and health savings accounts.

Client expense: $3,010,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Draft, To amend title XXVII of the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal Revenue Code of 1986 to require out- of-pocket expenditures for drugs to count towards an individuals deductible and out-of-pocket maximum. (no bill number) - Rep. Murphy, Greg - Requirements for deductibles and MOOP to include expenditures for DTC prescriptions H.R. 1 - One Big Beautiful Bill Act - Rep. Arrington, Jodey - Medicaid eligibility and state financing, Marketplace coverage and enrollment, Health Savings Account expansion, Pharmacy Benefit Manager financing and regulation H.R. 90 - Health Coverage Choice Act - Rep. Biggs, Andy - Duration of STLDHI plans H.R. 114 - Responsible Path to Full Obamacare Repeal Act - Rep. Biggs, Andy - ACA repeal H.R. 247 - Health Care Affordability Act - Rep. Underwood, Lauren - ACA tax credit extension H.R. 267 - Health Care Price Transparency Act - Rep. Davidson, Warren - Hospital and insurer transparency requirements H.R. 639 - Doctor Knows Best Act - Rep. Van Drew, Jefferson - Commercial market prior authorization H.R. 957 - Parity Enforcement Act - Rep. Norcross, Donald - Penalties for mental health parity violations H.R. 1385 - DOC Access Act - Rep. Carter, Earl Buddy - Rate setting for dental and optometric services H.R. 1397 - Increasing Access to Dental Insurance Act - Rep. Miller-Meeks, Mariannette - Standalone dental plans H.R. 1776 - New Health Options Act - Rep. Palmer, Gary - ACA reinsurance H.R. 2079 - Insurance Fraud Accountability Act - Rep. Ross, Deborah - fraudulent ACA enrollments H.R. 2199 - Restore Protections for Dialysis Patients Act - Rep. Kelly, Mike - ESRD coverage H.R. 2553 - Capping Prescription Costs Act - Rep. Horsford, Steven - Prescription cost-sharing H.R. 2554 - Lower Drug Costs for Families Act - Rep. Horsford, Steven - Commercial market drug rebates H.R. 2636 - Making Insulin Affordable for All Children Act - Rep. Landsman, Greg - Commercial market insulin cost-sharing H.R. 3020 - Addressing Anti-Competitive Health Care Contract Clauses Act - Rep. Spartz, Victoria - Study on anti-competitive contracting H.R. 3527 - Bridge to Medicaid Act - Rep. Sewell, Terri - ACA subsidies for non-Medicare expansion states H.R. 3701 - Family Vaccine Protection Act - Rep. Pallone, Frank - ACIP codification and vaccine coverage H.R. 4406 - State-Based Universal Health Care Act - Rep. Khanna, Ro - State-based universal health care H.R. 4710- No Surprises Act Enforcement Act - Rep. Murphy, Greg - Surprise billing penalties for noncompliance by health insurers H.R. 5145 - Bipartisan Premium Tax Credit Extension Act - Rep. Kiggans, Jennifer - Temporary extension of ACA enhanced premium tax credits H.R. 6171 - ACA Copay CAP Act of 2025 - Rep. Auchincloss, Jake - establish out of pocket limit on prescription drugs H.R. 6248 - Healthy Competition for Better Care Act - Rep. Arrington, Jodey - ban anticompetitive terms in contracts, promote higher quality, lower cost care H.R. 6703 - Lower Health Care Premiums for All Americans Act - Rep. Miller-Meeks, Mariannette - amend ERISA to lower premiums H.R. 7023 - Affordable CHOICE Act - Rep. Schakowsky, Janice - public option under ACA H.R. 7164 - Capping Costs for Consumers Act - Rep. Schrier, Kim - ACA cost-sharing reductions S. 46 - Health Care Affordability Act - Sen. Shaheen, Jeanne - ACA tax credit extension S. 729 - Hospital Transparency Compliance Enforcement Act - Sen. Kennedy, John - Hospital price transparency requirements S. 864 - HELP Copays Act - Sen. Marshall, Roger - Cost-sharing requirements S. 976 - Insurance Fraud Accountability Act - Sen. Wyden, Ron - fraudulent ACA enrollments S. 2355 - Patients Deserve Price Tags Act - Sen. Marshall, Roger - Hospital and insurer price transparency requirements S. 2420 - No Surprises Act Enforcement Act - Rep. Marshall, Roger - Surprise billing penalties for noncompliance by health insurers S. 2824 - A bill to amend the Internal Revenue Code of 1986 to extend the temporary enhanced premium tax credits - Sen. Murkowski, Lisa - Temporary extension of ACA enhanced premium tax credits S. 3599 - Affordable CHOICE Act - Sen. Whitehouse, Sheldon - public option under ACA S. 3990 - PrEP Access and Coverage Act - Sen. Smith, Tina - Coverage requirements for HIV services Issues related to implementation rule implementing the No Surprises Act prohibiting surprise medical bills; transparency report requirements; parity in mental health benefits; ERISA preemption; paperless delivery for health plan disclosures; Unauthorized Enrollments/Unauthorized Plan Switching; ACA Tax Credits (Inflation Reduction Act); final rule on Section 1557 of the ACA and its impact on Medigap plans; ACA Marketplace Enrollment and Agents and Brokers; Vaccine Coverage; Preventative Services Coverage; the Advanced Explanation of Benefits; coverage of weight loss drugs; Transparency in Coverage; No Surprises Act; ACA Marketplace Integrity; ACA Enhanced Tax Credits; Prior Authorization; health savings accounts; and potential changes to the VA community care program, including administration of community care.

Client expense: $5,320,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), SENATE, Veterans Affairs, Dept of (VA), White House Office

H.R. 1 - One Big Beautiful Bill Act - Rep. Arrington, Jodey - Medicaid eligibility and state financing, Marketplace coverage and enrollment, Health Savings Account expansion, Pharmacy Benefit Manager financing and regulation H.R. 90 - Health Coverage Choice Act - Rep. Biggs, Andy - Duration of STLDHI plans H.R. 114 - Responsible Path to Full Obamacare Repeal Act - Rep. Biggs, Andy - ACA repeal H.R. 247 - Health Care Affordability Act - Rep. Underwood, Lauren - ACA tax credit extension H.R. 267 - Health Care Price Transparency Act - Rep. Davidson, Warren - Hospital and insurer transparency requirements H.R. 639 - Doctor Knows Best Act - Rep. Van Drew, Jefferson - Commercial market prior authorization H.R. 957 - Parity Enforcement Act - Rep. Norcross, Donald - Penalties for mental health parity violations H.R. 1385 - DOC Access Act - Rep. Carter, Earl Buddy - Rate setting for dental and optometric services H.R. 1397 - Increasing Access to Dental Insurance Act - Rep. Miller-Meeks, Mariannette - Standalone dental plans H.R. 1776 - New Health Options Act - Rep. Palmer, Gary - ACA reinsurance H.R. 2079 - Insurance Fraud Accountability Act - Rep. Ross, Deborah - fraudulent ACA enrollments H.R. 2199 - Restore Protections for Dialysis Patients Act - Rep. Kelly, Mike - ESRD coverage H.R. 2553 - Capping Prescription Costs Act - Rep. Horsford, Steven - Prescription cost-sharing H.R. 2554 - Lower Drug Costs for Families Act - Rep. Horsford, Steven - Commercial market drug rebates H.R. 2636 - Making Insulin Affordable for All Children Act - Rep. Landsman, Greg - Commercial market insulin cost-sharing H.R. 3020 - Addressing Anti-Competitive Health Care Contract Clauses Act - Rep. Spartz, Victoria - Study on anti-competitive contracting H.R. 3527 - Bridge to Medicaid Act - Rep. Sewell, Terri - ACA subsidies for non-Medicare expansion states H.R. 3701 - Family Vaccine Protection Act - Rep. Pallone, Frank - ACIP codification and vaccine coverage H.R. 4406 - State-Based Universal Health Care Act - Rep. Khanna, Ro - State-based universal health care H.R. 4710- No Surprises Act Enforcement Act - Rep. Murphy, Greg - Surprise billing penalties for noncompliance by health insurers H.R. 5145 - Bipartisan Premium Tax Credit Extension Act - Rep. Kiggans, Jennifer - Temporary extension of ACA enhanced premium tax credits H.R. 6171 - ACA Copay CAP Act of 2025 - Rep. Auchincloss, Jake - establish out of pocket limit on prescription drugs H.R. 6248 - Healthy Competition for Better Care Act - Rep. Arrington, Jodey - ban anticompetitive terms in contracts, promote higher quality, lower cost care H.R. 6703 - Lower Health Care Premiums for All Americans Act - Rep. Miller-Meeks, Mariannette - amend ERISA to lower premiums S. 46 - Health Care Affordability Act - Sen. Shaheen, Jeanne - ACA tax credit extension S. 729 - Hospital Transparency Compliance Enforcement Act - Sen. Kennedy, John - Hospital price transparency requirements S. 864 - HELP Copays Act - Sen. Marshall, Roger - Cost-sharing requirements S. 976 - Insurance Fraud Accountability Act - Sen. Wyden, Ron - fraudulent ACA enrollments S. 2355 - Patients Deserve Price Tags Act - Sen. Marshall, Roger - Hospital and insurer price transparency requirements S. 2420 - No Surprises Act Enforcement Act - Rep. Marshall, Roger - Surprise billing penalties for noncompliance by health insurers S. 2824 - A bill to amend the Internal Revenue Code of 1986 to extend the temporary enhanced premium tax credits - Sen. Murkowski, Lisa - Temporary extension of ACA enhanced premium tax credits Issues related to implementation rule implementing the No Surprises Act prohibiting surprise medical bills; transparency report requirements; parity in mental health benefits; ERISA preemption; paperless delivery for health plan disclosures; Unauthorized Enrollments/Unauthorized Plan Switching; ACA Tax Credits (Inflation Reduction Act); final rule on Section 1557 of the ACA and its impact on Medigap plans; ACA Marketplace Enrollment and Agents and Brokers; Vaccine Coverage; Preventative Services Coverage; the Advanced Explanation of Benefits; coverage of weight loss drugs; Transparency in Coverage; No Surprises Act; ACA Marketplace Integrity; ACA Enhanced Tax Credits; Prior Authorization; and health savings accounts.

Client expense: $4,120,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), SENATE, White House Office