H.R. 5094 – Protect Patients from Costly Care Act

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Updated November 23, 2025 at 10:19 PM UTC

The Protect Patients from Costly Care Act rolls back two recent policy changes. It restores the original Medicaid cost‑sharing rules by undoing a 2025 amendment and cancels the money that had been set aside for that change. It also removes the exemption that kept orphan drugs out of Medicare’s drug‑price negotiation program, allowing those drugs to be negotiated like other medicines. The bill mainly affects Medicaid recipients, Medicare patients who need orphan drugs, and the federal agencies that manage these programs.

Key Provisions

Repeals the 2025 changes to Medicaid cost‑sharing rules that were added by Section 71120 of the recent reconciliation act, restoring the previous Medicaid cost‑sharing requirements.
Cancels any funding that had been allocated under the repealed Section 71120(c).
Repeals the 2025 provision that excluded orphan drugs from the Medicare drug‑price negotiation program, meaning orphan drugs will again be subject to price negotiations under Medicare.

Legislative Activity

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HouseIntro Referral Latest Action

Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.

Energy and Commerce Committee

September 2, 2025

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HouseIntro Referral

Introduced in House

September 2, 2025

HouseIntro Referral

Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.

Energy and Commerce Committee

September 2, 2025

Bill Text

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Introduced in HouseIssued September 2, 2025

I

119th CONGRESS

1st Session

H. R. 5094

IN THE HOUSE OF REPRESENTATIVES

September 2, 2025

Mr. Pappas (for himself, Mr. Jackson of Illinois, Mr. Ruiz, Ms. Norton, Mr. Fields, Mr. Larson of Connecticut, Ms. Goodlander, Mr. Thanedar, and Ms. Craig) introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned

A BILL

To repeal changes to Medicaid cost sharing requirements and the exclusion for orphan drugs under the Medicare Drug Price Negotiation Program.

1.

Short title

This Act may be cited as the Protect Patients from Costly Care Act.

2.

Repeal of changes to Medicaid cost sharing requirements

(a)

Repeal

Section 71120 of the Act titled An Act to provide for reconciliation pursuant to title II of H. Con. Res. 14 (Public Law 119–21) is repealed and title XIX of the Social Security Act (42 U.S.C. 1396 et seq.) shall be applied as if such section and the amendments made by such section had not been enacted.

(b)

Rescission

The amounts appropriated under section 71120(c) of the Act titled An Act to provide for reconciliation pursuant to title II of H. Con. Res. 14 (Public Law 119–21) are hereby rescinded.

3.

Repeal of changes to exclusion for orphan drugs under the Drug Price Negotiation Program

Section 71203 of the Act titled An Act to provide for reconciliation pursuant to title II of H. Con. Res. 14 (Public Law 119–21) is repealed and title XI of the Social Security Act (42 U.S.C. 1301 et seq.) shall be applied as if such section and the amendments made by such section had not been enacted.