US SB864

Requires health insurers to count financial assistance from non-profit organizations and drug manufacturers toward patients' deductibles, copayments, coinsurance, and out-of-pocket limits

Amends the Public Health Service Act and Affordable Care Act to ensure third-party payment assistance applies to cost-sharing requirements in group and individual health plans

Creates a safe harbor in the Internal Revenue Code allowing high-deductible health plans to count manufacturer and non-profit assistance for prescription drugs toward deductibles without losing HSA eligibility, effective for plan years after December 31, 2025

Applies to specialty drugs and drugs subject to utilization management, while preserving insurers' ability to use prior authorization and step therapy requirements

Takes effect for plan years beginning on or after January 1, 2026