[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[H.R. 830 Introduced in House (IH)]
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118th CONGRESS
1st Session
H. R. 830
To amend title XXVII of the Public Health Service Act to apply
additional payments, discounts, and other financial assistance towards
the cost-sharing requirements of health insurance plans, and for other
purposes.
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IN THE HOUSE OF REPRESENTATIVES
February 6, 2023
Mr. Carter of Georgia (for himself, Ms. Barragan, Mrs. Miller-Meeks,
Ms. DeGette, Mr. Fitzpatrick, Mrs. Watson Coleman, and Ms. Clarke of
New York) introduced the following bill; which was referred to the
Committee on Energy and Commerce
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A BILL
To amend title XXVII of the Public Health Service Act to apply
additional payments, discounts, and other financial assistance towards
the cost-sharing requirements of health insurance plans, and for other
purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Help Ensure Lower Patient Copays
Act'' or the ``HELP Copays Act''.
SEC. 2. APPLICATION OF ADDITIONAL PAYMENTS, DISCOUNTS, AND OTHER
FINANCIAL ASSISTANCE TOWARD COST-SHARING REQUIREMENTS.
(a) Application Toward Cost-Sharing Requirements.--Section
2715(g)(1) of the Public Health Service Act (42 U.S.C. 300gg-15(g)(1))
is amended by adding at the end the following: ``In developing the
standards for defining the terms `deductible', `co-insurance', `co-
payment', and `out-of-pocket limit' (as described in paragraph (2)),
such standards shall provide that such terms include amounts paid by,
or on behalf of, an individual enrolled in a group health plan or group
or individual health insurance coverage, including third-party
payments, financial assistance, discounts, product vouchers, and other
reductions in out-of-pocket expenses and that such amounts shall be
counted toward such deductible, co-insurance, co-payment, or limit,
respectively.''.
(b) Conforming Amendments.--
(1) PPACA.--Section 1302(c)(3) of the Patient Protection
and Affordable Care Act (42 U.S.C. 18022(c)(3)) is amended by
adding at the end the following new subparagraph:
``(C) Application of terms.--For purposes of
subparagraph (A), the terms `deductible',
`coinsurance', `copayment', or `similar charge' and any
other expenditure described in clause (ii) of such
subparagraph shall include amounts paid by, or on
behalf of, an individual enrolled in a group health
plan or group or individual health insurance coverage,
including third-party payments, financial assistance,
discounts, product vouchers, and other reductions in
out-of-pocket expenses and such amounts shall be
counted toward such deductible, coinsurance, copayment,
charge, or other expenditure, respectively.''.
(2) PHSA.--Section 2707(b) of the Public Health Service Act
(42 U.S.C. 300gg-6(b)) is amended by adding at the end the
following new sentence: ``For purposes of the previous
sentence, such limitation shall be applied as if the reference
to `essential health benefits' in section 1302(c)(3) of the
Patient Protection and Affordable Care Act were a reference to
`any item or service covered under the plan included within a
category of essential health benefits as described in (b)(1) of
such section'.''.
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