HELP Copays Act Reintroduced in the House, the Arthritis Foundation Urges Swift Passage
Measure seeks to ensure copay assistance and cost-sharing count toward patients’ annual limits.
Dec. 9, 2025 — The Arthritis Foundation, in union with other patient advocacy organizations, applauds the bipartisan group of House lawmakers for introducing H.R. 6423, the Help Lower Patient Copays Act (HELP Copays Act), legislation aimed at easing the financial burden on Americans who rely on costly medications to manage rare, serious and chronic health conditions.
The legislation targets two insurance and pharmacy benefit manager (PBM) practices that patient groups say leave vulnerable individuals with unexpected and unaffordable medical bills, including:
- Requiring health plans to count the value of copay assistance, often used by patients who depend on high-cost specialty drugs, toward a patient's out-of-pocket maximums. The Arthritis Foundation is in strong favor of this change as it would provide immediate financial relief for families already strained by rising premiums and copayments.
- Seek to close a loophole that allows some employer-sponsored plans to classify certain covered prescription drugs as "non-essential." Under current rules, doing so permits insurers to exclude patients' cost-sharing for these medications from their deductibles and annual out-of-pocket limits. The proposed legislation would require all private health plans to apply the cost-sharing for any covered service toward these totals.
In the letter thanking Congressional members for championing this legislation, the Arthritis Foundation emphasized its commitment to helping advance the HELP Copays Act, arguing that its passage would protect patients from harmful insurance practices and ensure that those with complex medical needs can access and afford the care their conditions require.
