Cancer Drug Parity Act of 2025

Key Points

• This bill requires employer-sponsored health plans to charge the same out-of-pocket costs for oral cancer drugs (pills taken at home) as they do for IV or injected cancer treatments given by a doctor. Right now, many plans charge much higher copays for oral medications, making them unaffordable for some patients.
• The bill only applies to oral cancer drugs that a doctor has determined are medically necessary or clinically appropriate for the patient. It doesn't force anyone to switch from IV treatments to pills.
• Insurance companies can't game the system by raising costs on other cancer treatments or making it harder to access oral drugs just to get around the new rules. The bill specifically blocks those workarounds.
• If enacted, the new cost-sharing rules would kick in for plan years starting on or after January 1, 2026. A GAO study would also be completed within two years to evaluate whether the law is actually reducing financial barriers for cancer patients.
• The bill amends ERISA, which governs employer-sponsored health plans. It does not directly apply to individual marketplace plans or government programs like Medicare or Medicaid, though it preserves stronger state-level protections where they exist.