[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 8270 Introduced in House (IH)]

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119th CONGRESS
  2d Session
                                H. R. 8270

  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 individual's deductible and out-of-pocket maximum.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             April 14, 2026

 Mr. Murphy (for himself, Mr. Moore of Utah, Mr. Barrett, Mr. Edwards, 
 and Ms. Tenney) introduced the following bill; which was referred to 
the Committee on Energy and Commerce, and in addition to the Committees 
  on Education and Workforce, and Ways and Means, for a period to be 
subsequently determined by the Speaker, in each case for consideration 
  of such provisions as fall within the jurisdiction of the committee 
                               concerned

_______________________________________________________________________

                                 A BILL


 
  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 individual's deductible and out-of-pocket maximum.

    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 ``Every Dollar Counts Act of 2026''.

SEC. 2. REQUIRING OUT-OF-POCKET EXPENDITURES FOR DRUGS TO COUNT TOWARDS 
              AN INDIVIDUAL'S DEDUCTIBLE AND OUT-OF-POCKET MAXIMUM.

    (a) PHSA.--Part D of title XXVII of the Public Health Service Act 
(42 U.S.C. 300gg-111 et seq.) is amended by adding at the end the 
following new section:

``SEC. 2799A-11. COUNTING OUT-OF-POCKET EXPENDITURES FOR CERTAIN DRUGS 
              TOWARDS A DEDUCTIBLE AND OUT-OF-POCKET MAXIMUM.

    ``A group health plan and a health insurance issuer offering group 
or individual health insurance coverage shall, in the case of an 
individual enrolled under such plan or coverage who elects to purchase 
a drug for which benefits are available under such plan or coverage 
without applying such benefits, count any out-of-pocket expenditures 
incurred by such individual with respect to such drug towards any 
deductible and out-of-pocket maximum that would have applied had such 
individual applied such benefits.''.
    (b) ERISA.--
            (1) In general.--Subpart B of part 7 of subtitle B of title 
        I of the Employee Retirement Income Security Act of 1974 (29 
        U.S.C. 1185 et seq.) is amended by adding at the end the 
        following new section:

``SEC. 726. COUNTING OUT-OF-POCKET EXPENDITURES FOR CERTAIN DRUGS 
              TOWARDS A DEDUCTIBLE AND OUT-OF-POCKET MAXIMUM.

    ``A group health plan and a health insurance issuer offering group 
health insurance coverage shall, in the case of a participant or 
beneficiary enrolled under such plan or coverage who elects to purchase 
a drug for which benefits are available under such plan or coverage 
without applying such benefits, count any out-of-pocket expenditures 
incurred by such participant or beneficiary with respect to such drug 
towards any deductible and out-of-pocket maximum that would have 
applied had such participant or beneficiary applied such benefits.''.
            (2) Clerical amendment.--The table of contents in section 1 
        of the Employee Retirement Income Security Act of 1974 (29 
        U.S.C. 1001 note) is amended by inserting after the item 
        relating to section 725 the following new item:

``Sec. 726. Counting out-of-pocket expenditures for certain drugs 
                            towards a deductible and out-of-pocket 
                            maximum.''.
    (c) IRC.--
            (1) In general.--Subchapter B of chapter 100 of the 
        Internal Revenue Code of 1986 is amended by adding at the end 
        the following new section:

``SEC. 9826. COUNTING OUT-OF-POCKET EXPENDITURES FOR CERTAIN DRUGS 
              TOWARDS A DEDUCTIBLE AND OUT-OF-POCKET MAXIMUM.

    ``A group health plan shall, in the case of an individual enrolled 
under such plan who elects to purchase a drug for which benefits are 
available under such plan without applying such benefits, count any 
out-of-pocket expenditures incurred by such individual with respect to 
such drug towards any deductible and out-of-pocket maximum that would 
have applied had such individual applied such benefits.''.
            (2) Clerical amendment.--The table of sections for 
        subchapter B of chapter 100 of the Internal Revenue Code of 
        1986 is amended by adding at the end the following new item:

``Sec. 9826. Counting out-of-pocket expenditures for certain drugs 
                            towards a deductible and out-of-pocket 
                            maximum.''.
    (d) Conforming Amendments.--
            (1) Best price.--Section 1927(c)(1)(C)(ii) of the Social 
        Security Act (42 U.S.C. 1396r-8(c)(1)(C)(ii)) is amended--
                    (A) in subclause (IV), by striking ``and'' at the 
                end;
                    (B) in subclause (V), by striking the period at the 
                end and inserting ``; and''; and
                    (C) by adding at the end the following new 
                subclause:
                                    ``(VI) shall exclude any reduction 
                                in price with respect to an individual 
                                purchasing such drug without applying 
                                any benefits under a group health plan 
                                (as defined in section 2791 of the 
                                Public Health Service Act), group or 
                                individual health insurance coverage 
                                (as so defined), or a Federal health 
                                care program (as defined in section 
                                1128B but including the program 
                                established under chapter 89 of title 
                                5, United States Code).''.
            (2) Average manufacturer price.--Section 1927(k)(1)(B)(i) 
        of the Social Security Act (42 U.S.C. 1396r-8(k)(1)(B)(i)) is 
        amended--
                    (A) in subclause (VII), by striking ``and'' at the 
                end;
                    (B) in subclause (VIII), by striking the period at 
                the end and inserting ``; and''; and
                    (C) by adding at the end the following new 
                subclause:
                                    ``(IX) any reduction in price with 
                                respect to an individual purchasing 
                                such drug without applying any benefits 
                                under a group health plan (as defined 
                                in section 2791 of the Public Health 
                                Service Act), group or individual 
                                health insurance coverage (as so 
                                defined), or a Federal health care 
                                program (as defined in section 1128B 
                                but including the program established 
                                under chapter 89 of title 5, United 
                                States Code).''.
    (e) Effective Date.--The amendments made by subsections (a) through 
(c) shall apply with respect to plan years beginning on or after 
January 1, 2027.
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