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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 establish requirements with respect to cost sharing for epinephrine delivery systems under group health plans and group and individual health insurance coverage.
Summary
The bill requires health insurance plans and coverage to limit patient cost-sharing for epinephrine delivery systems (such as EpiPens and alternative auto-injectors, nasal sprays, and sublingual formulations) to no more than $60 per package of two delivery systems. Plans cannot require a deductible for these medications and must count any cost-sharing paid toward patients' overall deductibles and out-of-pocket maximums. The requirements apply to group and individual health insurance plans starting with plan years beginning January 1, 2026. Out-of-network providers may be subject to higher cost-sharing limits under the bill's provisions.
AI-generated plain-language summary of the bill text — neutral, and may be imperfect. See the full text below for the exact wording.
Sponsor (1)
1 cosponsor
Money behind the sponsor
Top reported contributors to Maxwell Frost’s campaign committee (2024 cycle) — who funds the bill’s sponsor, not a claim about this bill. Data from FEC.
- VLP LAW $13,200
- SMARTHINKING $13,200
- BAD ROBOT PRODUCTIONS $13,200
- AMSCOT FINANCIAL, INC. $8,500
- ADVENT HEALTH $6,750
Organizations whose employees gave the most — itemized individual contributions grouped by the donor’s reported employer (FEC Schedule A). Full finance for Maxwell Frost → · Outside spending →
Actions (2)
- Sep 4, 2025 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. · house
- Sep 4, 2025 Introduced in House
Similar bills (6)
Bills with similar text or summary — includes reintroductions across Congresses. Ranked by semantic similarity of the bill text (computed locally); a neutral discovery aid, not a claim the bills are duplicates.
Text versions (1)
Bills are re-published as they move (Introduced → Reported → Engrossed → Enrolled …). Each stage below is a separate text; pick two to see what changed. Data from Congress.gov.
Full text
IN THE HOUSE OF REPRESENTATIVES
September 4, 2025
Mr. Frost (for himself and Ms. Matsui) 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 establish requirements with respect to cost sharing for epinephrine delivery systems under group health plans and group and individual health insurance coverage.
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 “Epinephrine’s Pharma Inflated Price Ends Now Act” or the “EPIPEN Act”.
SEC. 2. REQUIREMENTS WITH RESPECT TO COST SHARING FOR EPINEPHRINE DELIVERY SYSTEMS.
(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. REQUIREMENTS WITH RESPECT TO COST SHARING FOR EPINEPHRINE DELIVERY SYSTEMS.
“(a) In General.—A group health plan, and a health insurance issuer offering group or individual health insurance coverage, shall provide coverage of epinephrine delivery systems, and with respect to such delivery systems, may not—
“(1) apply any deductible; or
“(2) impose any cost sharing in excess of $60 per package of 2 delivery systems (or the equivalent).
“(b) Application of Cost Sharing Toward Deductibles and Out-of- Pocket Maximums.—Any cost-sharing payments made pursuant to subsection
(a)(2) shall be counted toward any deductible or out-of-pocket maximum that applies under the plan or coverage.
“(c) Out-of-Network Providers.—Nothing in this section requires a plan or issuer that has a network of providers to provide benefits for an epinephrine delivery system described in this section that is delivered by an out-of-network provider, or precludes a plan or issuer that has a network of providers from imposing higher cost sharing than the levels specified in subsection (a)(2) for an epinephrine delivery system described in this section that is delivered by an out-of-network provider.
“(d) Epinephrine Delivery System Defined.—In this section, the term ‘epinephrine delivery system’ means a delivery system approved by the Food and Drug Administration for the administration of epinephrine, including any auto-injector, nasal spray, or sublingual delivery system that is so approved.”.
(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. REQUIREMENTS WITH RESPECT TO COST SHARING FOR EPINEPHRINE DELIVERY SYSTEMS.
“(a) In General.—A group health plan, and a health insurance issuer offering group health insurance coverage, shall provide coverage of epinephrine delivery systems, and with respect to such delivery systems, may not—
“(1) apply any deductible; or
“(2) impose any cost sharing in excess of $60 per package of 2 delivery systems (or the equivalent).
“(b) Application of Cost Sharing Toward Deductibles and Out-of- Pocket Maximums.—Any cost-sharing payments made pursuant to subsection
(a)(2) shall be counted toward any deductible or out-of-pocket maximum that applies under the plan or coverage.
“(c) Out-of-Network Providers.—Nothing in this section requires a plan or issuer that has a network of providers to provide benefits for an epinephrine delivery system described in this section that is delivered by an out-of-network provider, or precludes a plan or issuer that has a network of providers from imposing higher cost sharing than the levels specified in subsection (a)(2) for an epinephrine delivery system described in this section that is delivered by an out-of-network provider.
“(d) Epinephrine Delivery System Defined.—In this section, the term ‘epinephrine delivery system’ means a delivery system approved by the Food and Drug Administration for the administration of epinephrine, including any auto-injector, nasal spray, or sublingual delivery system that is so approved.”.
(2) Clerical amendment.—The table of contents in section 1 of the Employee Retirement Income Security Act of 1974 (29 U.S.C. 1001 et seq.) is amended by inserting after the item relating to section 725 the following:
“Sec. 726. Requirements with respect to cost sharing for epinephrine delivery systems.”.
(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. REQUIREMENTS WITH RESPECT TO COST SHARING FOR EPINEPHRINE DELIVERY SYSTEMS.
“(a) In General.—A group health plan shall provide coverage of epinephrine delivery systems, and with respect to such delivery systems, may not—
“(1) apply any deductible; or
“(2) impose any cost sharing in excess of $60 per package of 2 delivery systems (or the equivalent).
“(b) Application of Cost Sharing Toward Deductibles and Out-of- Pocket Maximums.—Any cost-sharing payments made pursuant to subsection
(a)(2) shall be counted toward any deductible or out-of-pocket maximum that applies under the plan.
“(c) Out-of-Network Providers.—Nothing in this section requires a plan that has a network of providers to provide benefits for an epinephrine delivery system described in this section that is delivered by an out-of-network provider, or precludes a plan that has a network of providers from imposing higher cost sharing than the levels specified in subsection (a)(2) for an epinephrine delivery system described in this section that is delivered by an out-of-network provider.
“(d) Epinephrine Delivery System Defined.—In this section, the term ‘epinephrine delivery system’ means a delivery system approved by the Food and Drug Administration for the administration of epinephrine, including any auto-injector, nasal spray, or sublingual delivery system that is so approved.”.
(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. Requirements with respect to cost sharing for epinephrine delivery systems.”.
(d) Effective Date.—The amendments made by this section shall apply with respect to plan years beginning on or after January 1, 2026. <all>
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