We have received text from H.R. 4101: Cancer Drug Parity Act of 2025. This bill was received on 2025-06-24, and currently has 12 cosponsors.
Here is a short summary of the bill:
The Cancer Drug Parity Act of 2025 aims to amend the Employee Retirement Income Security Act of 1974 to establish rules regarding the cost-sharing of oral anticancer medications. Here are the main points of the bill:
Purpose
The bill intends to ensure that health insurance plans provide cost-sharing for oral anticancer drugs that is as favorable as the costs associated with intravenous or injectable anticancer drugs administered in a healthcare setting.
Key Provisions
- Cost-Sharing Parity: Insurance plans must treat oral anticancer medications the same as other anticancer treatments. If a plan covers drugs given by a healthcare provider, it must also offer similar terms for prescribed oral anticancer drugs.
- Medically Necessary Treatments: The bill applies only to those oral anticancer medications that are deemed medically necessary by a physician. This includes drugs that are approved by the FDA and are necessary for killing, slowing, or preventing the growth of cancerous cells.
- No Increased Costs: Plans cannot make changes that would result in higher out-of-pocket costs for patients regarding anticancer medications. This includes restrictions that could impose more costly measures for orally administered medications compared to those administered by a provider.
- Utilization Controls: The bill does not prevent insurance plans from utilizing prior authorizations or other appropriate methods of controlling the use of anticancer drugs.
- State Law Protections: If a state law provides greater protection regarding the coverage of orally administered anticancer medications, that state law will still apply regardless of the federal law.
- Definition of Cost-Sharing: The term 'cost-sharing' includes deductibles, coinsurance, copayments, and any maximum limits on these out-of-pocket costs.
Implementation Timeline
The new requirements will apply to health plans for plan years beginning on or after January 1, 2026.
Study Requirement
Within two years of the bill's enactment, the Government Accountability Office (GAO) will conduct a study to assess the impact of these new cost-sharing provisions. This study will compare out-of-pocket costs for individuals under the newly enforced sections with those who are not covered by them. The GAO will provide recommendations to Congress on how to improve access to these medications for individuals with health insurance plans.
Relevant Companies
- AMGN (Amgen Inc.): Amgen manufactures several oral cancer medications and may be impacted by changes in cost-sharing policies required by the bill.
- ABBV (AbbVie Inc.): AbbVie produces oral drugs for cancer treatment and could experience changes in demand based on insurance coverage modifications.
- NVS (Novartis AG): Novartis markets oral anticancer therapies and may be affected by alterations in insurance plan structures regarding these drugs.
Representative Glenn Grothman Bill Proposals
Here are some bills which have recently been proposed by Representative Glenn Grothman:
- H.R.4178: To amend the Balanced Budget and Emergency Deficit Control Act of 1985 to provide for discretionary spending limits for each of fiscal years 2026 through 2029, and for other purposes.
- H.R.4101: Cancer Drug Parity Act of 2025
- H.R.3967: CREATE JOBS Act
- H.R.3912: Stop the Baseline Bloat Act of 2025
- H.R.3540: Low-Income Housing Tax Credit Elimination Act
- H.R.3342: BOP Direct-Hire Authority Act
You can track bills proposed by Representative Glenn Grothman on Quiver Quantitative's politician page for Grothman.
Representative Glenn Grothman Net Worth
Quiver Quantitative estimates that Representative Glenn Grothman is worth $2.0M, as of July 8th, 2025. This is the 218th highest net worth in Congress, per our live estimates.
Grothman has approximately $8.7K invested in publicly traded assets which Quiver is able to track live.
You can track Representative Glenn Grothman's net worth on Quiver Quantitative's politician page for Grothman.
Representative Glenn Grothman Stock Trading
We have data on up to $75.0K of trades from Representative Glenn Grothman, which we parsed from STOCK Act filings.
You can track Representative Glenn Grothman's stock trading on Quiver Quantitative's politician page for Grothman.
This article is not financial advice. See Quiver Quantitative's disclaimers for more information.
