Hepatitis C Elimination Plan Launches $5.5 Billion Drug Subscription Program, Eliminating Patient Costs

The “Cure Hepatitis C Act of 2025” is a massive federal effort aimed squarely at wiping out Hepatitis C (HCV) in the U.S. This isn't just about grants; it sets up a radical new system for how the government buys medicine and who gets it for free. The core idea is simple: make the cure accessible to those who need it most, regardless of their ability to pay, using a novel drug purchasing model.

The All-You-Can-Treat Drug Subscription

The biggest change here is the creation of a federal Subscription Drug Purchase Program (Sec. 4). Think of it like Netflix for HCV medication. Instead of buying drug bottles one by one, the Secretary of Health and Human Services (HHS) will sign five-year contracts with drug manufacturers, paying a fixed annual fee for unlimited doses of the direct-acting antiviral treatments needed for the “covered population.” This population includes people on Medicaid/CHIP (if the state opts in), those in state or federal prisons, people receiving care through the Indian Health Service (IHS), and anyone who is uninsured. For these groups, the treatment will be completely free—zero co-pay, zero deductible. This model is designed to drive down the per-patient cost for the government by guaranteeing massive volume.

Who Gets the Free Treatment and Who Pays

If you fall into one of those covered groups and are diagnosed with HCV, this bill is a game-changer. For instance, if you’re a working parent who relies on Medicaid, or if you’re uninsured and have been putting off treatment because of the cost, the drug itself will now be supplied free of charge. The bill dedicates $5.5 billion for this specific subscription program (Sec. 4). Critically, state and local correctional systems that participate must ensure that individuals released from custody get the rest of their treatment and are linked to ongoing care, addressing a huge public health gap (Sec. 4).

The Medicare Cost-Cut

For those 65 and older, the bill also tackles Medicare Part D costs (Sec. 7). Starting in 2027 (or potentially 2028 if the Secretary decides implementation isn't practical), Medicare beneficiaries will pay zero deductible, co-insurance, or co-pay for these specific Hepatitis C treatments through 2031. This is a huge win for seniors and people with disabilities on Medicare, who often face high out-of-pocket costs even for essential, life-saving drugs.

Billions for Outreach and Testing

Beyond the treatment itself, the bill authorizes $4.283 billion for public health activities through 2031 (Sec. 6). This money isn't for drugs; it’s for getting people tested and into treatment. HHS will issue grants to states and local entities to boost screening, diagnosis, and support services. The bill specifically targets high-risk settings like opioid treatment programs, behavioral health clinics, community health centers, and correctional facilities (Sec. 5). This means if you live in an area struggling with the opioid crisis, you should see a significant increase in accessible testing and linkage-to-care services right where you are already receiving other health services.

The Fine Print: Complications and Exclusions

While the program aims for broad access, it introduces some administrative complexity and hard limits. First, any pharmacy or clinic receiving the free subscription drugs cannot use the federal 340B drug discount program for those same doses (Sec. 4). This rule prevents double-dipping, but it requires careful tracking by providers, especially large hospitals and community health centers that rely heavily on 340B savings.

More concerning is Section 10, which governs who can receive services funded by the public health activities grants. This section restricts eligibility to a very specific, narrow list of U.S. citizens and legal residents (like permanent residents, refugees, and those with specific parole statuses). If you are lawfully present in the U.S. but do not fit one of those specific immigration categories—which can be a surprisingly common situation—you may be excluded from the federally funded screening, outreach, and support services provided under this act, even if you are at high risk for HCV. This creates a potential gap where public health efforts may not reach all populations in need, despite the goal of elimination.