II 

118TH CONGRESS 

1ST SESSION S. 1375 

To amend title XXVII of the Public Health Service Act to apply additional 

payments, discounts, and other financial assistance towards the costsharing requirements of health insurance plans, and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

APRIL 27, 2023 

Mr. MARSHALL (for himself, Mr. KAINE, Ms. ERNST, Mr. MARKEY, and Ms. 

MURKOWSKI) introduced the following bill; which was read twice and referred to the Committee on Health, Education, Labor, and Pensions 

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. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Help Ensure Lower 

5 Patient Copays Act’’ or the ‘‘HELP Copays Act’’. 


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1 SEC. 2. APPLICATION OF ADDITIONAL PAYMENTS, DIS2 COUNTS, AND OTHER FINANCIAL ASSIST3 ANCE TOWARD COST-SHARING REQUIRE4 MENTS. 

5 (a) APPLICATION TOWARD COST-SHARING REQUIRE6 MENTS.—Section 2715(g)(1) of the Public Health Service 

7 Act (42 U.S.C. 300gg–15(g)(1)) is amended by adding at 

8 the end the following: ‘‘In developing the standards for 

9 defining the terms ‘deductible’, ‘co-insurance’, ‘co-pay10 ment’, and ‘out-of-pocket limit’ (as described in paragraph 

11 (2)), such standards shall provide that such terms include 

12 amounts paid by, or on behalf of, an individual enrolled 

13 in a group health plan or group or individual health insur14 ance coverage, including third-party payments, financial 

15 assistance, discounts, product vouchers, and other reduc16 tions in out-of-pocket expenses and that such amounts 

17 shall be counted toward such deductible, co-insurance, co18 payment, or limit, respectively.’’. 

19 (b) CONFORMING AMENDMENTS.— 

20 (1) PPACA.—Section 1302(c)(3) of the Patient 

21 Protection and Affordable Care Act (42 U.S.C. 

22 18022(c)(3)) is amended by adding at the end the 

23 following new subparagraph: 

24 ‘‘(C) APPLICATION OF TERMS.—For pur25 poses of subparagraph (A), the terms ‘deduct26 ible’, ‘coinsurance’, ‘copayment’, or ‘similar 


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1 charge’ and any other expenditure described in 

2 clause (ii) of such subparagraph shall include 

3 amounts paid by, or on behalf of, an individual 

4 enrolled in a group health plan or group or in5 dividual health insurance coverage, including 

6 third-party payments, financial assistance, dis7 counts, product vouchers, and other reductions 

8 in out-of-pocket expenses and such amounts 

9 shall be counted toward such deductible, coin10 surance, copayment, charge, or other expendi11 ture, respectively.’’. 

12 (2) PHSA.—Section 2707(b) of the Public 

13 Health Service Act (42 U.S.C. 300gg–6(b)) is 

14 amended by adding at the end the following new 

15 sentence: ‘‘For purposes of the previous sentence, 

16 such limitation shall be applied as if the reference to 

17 ‘essential health benefits’ in section 1302(c)(3) of 

18 the Patient Protection and Affordable Care Act were 

19 a reference to ‘any item or service covered under the 

20 plan included within a category of essential health 

21 benefits as described in (b)(1) of such section’.’’. 

Æ 


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