This Act caps out-of-pocket costs for essential prescription inhalers and nebulizers at a maximum of \$15 per 30-day supply for most insured and establishes a new assistance program for uninsured individuals.
Kweisi Mfume
Representative
MD-7
The Affordable Inhalers and Nebulizers Act of 2025 aims to significantly reduce patient out-of-pocket costs for essential prescription inhalers and nebulizers used to treat conditions like asthma and COPD. This bill caps patient cost-sharing for these products at a maximum of \$15 per 30-day supply for most private insurance and Medicare beneficiaries, effective in 2026. Additionally, it establishes a new program to provide similar cost relief for uninsured individuals. The legislation ensures that payments made toward these caps count toward deductibles and out-of-pocket maximums.
Inhaler Costs Capped at $15 Monthly for All Insurance Plans Starting 2026
The Affordable Inhalers and Nebulizers Act of 2025 is laser-focused on one thing: making sure people with asthma, COPD, and other breathing disorders don't have to choose between paying rent and breathing. Starting in 2026, this bill mandates a hard cap on how much you can be charged for prescription inhalers and the equipment used to deliver the medicine.
The $15 Cap: What It Means for Your Wallet
For anyone juggling a chronic condition, the cost of maintenance drugs is a massive, often unpredictable expense. This bill cuts through that uncertainty by establishing a maximum patient cost-sharing of $15 for a 30-day supply of any 'specified inhaler product.' This applies across the board, whether you get your insurance through work, buy it on the marketplace, or are covered by Medicare Part B or Part D. For example, if your current copay for a rescue inhaler is $50, that cost drops to $15 as of January 1, 2026.
Crucially, the bill also eliminates the deductible for these products. If you have private insurance, your plan cannot make you meet your annual deductible before they start covering your inhalers. This is a game-changer, especially for those with High Deductible Health Plans (HDHPs). The bill explicitly states that waiving the deductible for these essential drugs will not cause an HDHP to lose its tax-advantaged status. Any amount you do pay toward that $15 cap must still count toward your overall annual out-of-pocket maximum, providing full financial credit for your spending.
Medicare and the Uninsured Get Relief
Medicare patients often face complex cost-sharing rules, but this bill simplifies things dramatically. For both Part B (outpatient drugs) and Part D (prescription plans), the standard deductible is waived for specified inhalers starting in 2026, and the patient cost-sharing is capped at that same $15 per 30-day supply. This is particularly helpful for seniors and disabled individuals relying on fixed incomes.
Perhaps the most significant provision addresses the uninsured. The Secretary of Health and Human Services (HHS) must create a program allowing healthcare providers to supply inhalers to uninsured individuals and then bill HHS for reimbursement. The catch for providers is that they cannot charge the uninsured patient more than $15 for that 30-day supply. This creates a safety net, ensuring that even those without coverage can access necessary, capped-cost medication without facing crippling hospital bills or rationing their supply.