Affordable Inhalers and Nebulizers Act of 2025
Affordable Inhalers and Nebulizers Act of 2025 would create a uniform, low-cost-sharing standard for prescription inhaler products used to treat asthma and COPD across private insurance, Medicare, and ERISA-regulated plans. The core idea is to eliminate deductibles and cap cost-sharing at $15 per 30-day supply for all defined “specified inhaler products,” which include inhaled medications (maintenance, reliever, rescue) and related administration devices (masks, tubing, spacers, nebulizers, etc.). Those cost-sharing amounts would be counted toward any applicable deductible and out-of-pocket maximum, ensuring that the $15 cap contributes to overall affordability rather than simply being a separate payment. The bill also creates a new program to help uninsured individuals obtain specified inhaler products at no more than a $15 per 30-day supply, starting in 2026. It extends these protections to Medicare under Parts B and D and makes conforming adjustments in the tax code and ERISA to ensure consistency across coverage types. In addition, it provides safe harbors for high-deductible health plans and updates to the overall insurance framework to accommodate the new price protection. Overall, the measure aims to reduce cost barriers to essential inhaler therapies, potentially improving adherence and health outcomes for people with asthma and COPD, while imposing new federal policy requirements and potential cost to the government.
Key Points
- 1Uniform $15 per 30-day supply cap and no deductible for specified inhaler products across private insurance (PHSA Part D), the Internal Revenue Code, and ERISA plans; cost-sharing on these products must not exceed $15 and must count toward deductibles and out-of-pocket maximums.
- 2Specified inhaler product defined broadly to include maintenance, reliever, or rescue inhalers (in all delivery forms) plus related administration equipment (eg, masks, spacers, nebulizers, tubing, etc.) with medically accepted indications for asthma or COPD.
- 3Medicare provisions extended to Parts B and D starting in 2026: deductible no longer applies to specified inhaler products, and cost-sharing for these products is capped and calculated relative to standard Medicare payment rules, with the cap set at $15 per 30-day supply.
- 4Safe harbors and plan design changes: adds safe harbors to keep inhaler products from breaking HDHP rules and updates catastrophic plan designations to recognize the new inhaler cost-sharing framework.
- 5Uninsured patient program: creates Specified Inhaler Product Payment Program (beginning 2026) where providers can dispense inhaler products to uninsured individuals and be reimbursed by the Secretary (subject to appropriations), with providers agreeing not to charge more than $15 per 30-day supply to the patient.