Members of the 119th Congress have reintroduced The Help Ensure Lower Patient Copays Act (HELP Copays Act), S.864,, which aims to protect patients by ensuring that all payments, whether from their own pockets or through copay assistance, count towards cost-sharing obligations. .
Many patients rely on financial assistance to help meet copay obligations, but copay accumulator programs prevent it from counting toward deductibles or out-of-pocket limits. Once this assistance runs out, patients face unaffordable costs, often forcing them to skip or stop treatment, leading to worsening health and higher healthcare costs. Furthermore, mid-year health plan changes can leave patients without support, further exacerbating financial and medical challenges.
The HELP Copays Act would require all health plans to apply copay assistance toward a patient’s deductible and out-of-pocket maximum, ensuring individuals can continue their treatment without financial barriers. It would also close a loophole that allows employer-sponsored plans to classify certain covered drugs as “non-essential,” which lets insurers avoid applying cost-sharing expenses toward patients’ deductibles and out-of-pocket limits.
By eliminating these unfair practices, the HELP Copays Act will remove financial barriers to care and improve health outcomes for patients. Read S.864 here. Learn more about copay accumulators here.
Last Updated on March 24, 2025 by Aimed Alliance
