HELP Copays Act

119th Congress Introduced by Alma Adams and 54 co-sponsors

Expands Title XXVII PHSA aid to cover health-plan cost-sharing (deductibles, copays, coinsurance), lowering enrollees’ out-of-pocket costs and improving affordability.

Introduced in House

Overview

HR 6423 is a House-originating bill titled: “To amend title XXVII of the Public Health Service Act to apply financial assistance towards the cost-sharing requirements of health insurance plans, and for other purposes.” The central aim appears to be expanding or directing financial assistance to cover cost-sharing (such as deductibles, copayments, and coinsurance) within health insurance plans that fall under Title XXVII of the Public Health Service Act (PHSA).

Purpose and Intent

To modify the Financial Assistance framework within Title XXVII of the PHSA so that financial support (assistance typically provided to help with health care costs) is applied toward the cost-sharing obligations of health insurance plans.

The broader goal is to reduce out-of-pocket costs for enrollees in participating plans, improving affordability of care for insured individuals.

Key Provisions (expected scope based on the bill’s title)

Note: Specific text of provisions is not provided here. Based on the bill’s description, the following are the likely areas of change:
- Amend Title XXVII of the Public Health Service Act to redefine or expand how financial assistance is used.
- Direct or broaden the use of federal financial support to cover patient cost-sharing (deductibles, copays, coinsurance) within eligible health insurance plans.
- Clarify eligibility criteria for plans and/or enrollees benefiting from the cost-sharing assistance.
- Include “for other purposes” language that may authorize related or supplementary provisions (e.g., administrative processes, reporting requirements, or related programmatic changes).

Affected Parties

Enrollees in health insurance plans that receive financial assistance under Title XXVII of the PHSA (potential beneficiaries of reduced cost-sharing).

Health insurance issuers and entities participating in Title XXVII programs (due to altered funding and eligibility rules).

Federal programs and offices administering PHSA Title XXVII financial assistance.

Procedural Status and Timeline

Introduced in the House on December 4, 2025.

Referred on the same day to:

Committee on Energy and Commerce
Committee on Ways and Means for consideration of provisions within their jurisdiction.

The referral is “for a period to be subsequently determined by the Speaker,” indicating ongoing committee review with future scheduling decisions pending.

Potential Impact (high-level)

Financial: Possible changes to federal outlay related to Title XXVII program funding, with direct implications for the amount and distribution of cost-sharing assistance.

Access and affordability: If enacted as described, could reduce out-of-pocket costs for enrollees in affected plans, potentially increasing affordability and utilization of care.

Administrative: May introduce new or revised administration, reporting, and oversight requirements for programs implementing cost-sharing assistance.

Next Steps

Monitor committee action from Energy and Commerce and Ways and Means for any amendments, hearings, or reports.

Review the bill’s text upon release of a full version to assess precise definitions, eligibility, funding levels, duration, and any pilot or sunset provisions.

Assess fiscal impact and implementation considerations with stakeholders (health plans, providers, and beneficiaries).

Bill