Cure Hepatitis C Act of 2026
- Sponsor
- Rep. Miller-Meeks, Mariannette [R-IA-1]
- Committees
- Ways and Means Committee (primary)
- Last action
- Jul 14, 2026
Bottom line
The bill creates a federally-funded, multi-pronged program to eliminate hepatitis C by expanding access to treatment through a novel drug procurement model and supporting public health infrastructure.
What it actually does
This bill establishes a comprehensive federal program to eliminate hepatitis C virus in the United States. It creates a subscription model for the federal government to purchase hepatitis C treatments for specific vulnerable populations, including those on Medicaid/CHIP, incarcerated individuals, the uninsured, and those served by Indian Health Programs. Additionally, it funds public health activities to support screening, diagnosis, and treatment, and eliminates cost-sharing for hepatitis C drugs under Medicare Part D.
Proponents argue
Supporters argue that this bill addresses a critical public health crisis by providing a clear pathway to eliminate hepatitis C, a curable disease that disproportionately affects vulnerable populations. They contend that the subscription model for drug procurement will significantly reduce treatment costs and expand access, ultimately saving lives and reducing long-term healthcare expenditures associated with chronic hepatitis C.
Opponents contend
Critics may raise concerns about the substantial federal spending authorized by the bill, questioning its long-term fiscal sustainability. Some may also argue that the federal government's direct involvement in drug procurement through a subscription model could distort pharmaceutical markets or create unintended consequences for drug development and pricing, while others might focus on potential administrative complexities in coordinating such a broad program across multiple agencies and state systems.
The bill is moderately complex, requiring careful reading to understand the new program structures, funding mechanisms, and specific eligibility criteria. The estimated reading time is appropriate for a thorough review.
Section 3
Hepatitis C Elimination Program Establishment
This section requires the Secretary of Health and Human Services (HHS) to establish a 'Hepatitis C Elimination Program' within 90 days of enactment. It mandates the development of a national strategy and implementation plan, including goals, objectives, and performance metrics. The program will also feature an advisory committee, an interagency working group, a public dashboard to monitor progress, and require annual reports to Congress.
Supporters argue
Supporters argue that a centralized, coordinated program with clear goals and metrics is essential for effectively tackling a widespread public health issue like hepatitis C. The advisory committee and interagency group ensure broad expertise and collaboration, while the public dashboard promotes accountability.
Critics contend
Some may argue that establishing new committees and working groups could lead to bureaucratic inefficiencies or delays in implementation. Concerns might be raised about the administrative costs associated with such a comprehensive program structure.
Tradeoffs
The tension lies between the need for comprehensive coordination and the potential for administrative overhead. While a structured program is vital, balancing oversight with agile implementation will be key.
Section 4(b)
Hepatitis C Treatment Subscription Program
This section establishes a subscription program where the Secretary of HHS will enter agreements with drug manufacturers to purchase unlimited hepatitis C treatments for a fixed annual amount over five years. These treatments will be distributed to registered pharmacies, correctional facilities (state, local, and federal), and Indian Health Service facilities, and provided without cost-sharing to eligible individuals. Covered populations include Medicaid/CHIP enrollees in participating states, incarcerated individuals, the uninsured, and those receiving care through Indian Health Programs.
Section 5(a) and (b)
Public Health Activities and State Awards
This section authorizes HHS to make grants and awards to states, political subdivisions, and various healthcare entities to support public health activities for hepatitis C elimination. State awards will facilitate screening, diagnosis, treatment, and wraparound services for at-risk individuals, with funds allocated based on incidence and covered population size. Other awards target specific settings like opioid treatment programs, tribal areas, community health centers, correctional facilities, and Ryan White clinics, aiming to expand testing, linkage to care, and treatment capacity.
Section 7
Elimination of Medicare Part D Cost-Sharing for Hepatitis C Treatments
This section amends the Social Security Act to eliminate deductibles, coinsurance, and other cost-sharing for direct-acting antiviral drugs used to treat hepatitis C under Medicare Part D. This change will apply for plan years 2028 through 2032. The Secretary of HHS is granted authority to delay implementation by one year, to 2029, if it is determined not feasible to begin in 2028. Conforming amendments are also made for low-income individuals.
Prohibits healthcare providers, pharmacies, and sites of dispensing from utilizing any other Federal drug discount program, including the 340B program, with respect to hepatitis C treatments obtained through the new subscription program.
Section 4(b)(1)(B)
Why it matters:This is standard legislative practice to prevent 'double-dipping' or conflicting federal subsidies, but it is highly consequential for entities participating in both programs.
Case for: Proponents argue this prevents covered entities from receiving both the deeply discounted subscription price and a 340B discount for the same drug, ensuring fiscal integrity and preventing unintended market distortions. It clarifies the funding streams.
Case against: Critics might argue this adds significant administrative complexity for 340B covered entities, requiring them to track and segregate hepatitis C treatments obtained through the new program from those purchased via 340B. This could lead to compliance challenges and potential errors.
Estimated impact: This provision will significantly impact the operational procedures and compliance requirements for thousands of 340B covered entities that treat hepatitis C patients.
Excludes any prices charged under the new hepatitis C treatment subscription program from being used in the calculation of Medicaid 'best price' and 'average manufacturer price' (AMP).
Section 4(c)
Why it matters:This is a common legislative technique to prevent a new federal procurement program from inadvertently lowering the 'best price' or AMP for Medicaid, which could force manufacturers to pay higher rebates to state Medicaid programs. It's a technical fix to protect manufacturers from unintended consequences of the new pricing model.
Case for: Proponents argue this is essential to ensure manufacturers are willing to participate in the subscription model. Without this exclusion, the deeply discounted subscription price could trigger significantly higher Medicaid rebates across the board, making the subscription program financially unviable for manufacturers.
Case against: Critics might argue that this provision reduces transparency in drug pricing and could limit the ability of Medicaid programs to secure the lowest possible prices for other drugs. It could be seen as a concession to pharmaceutical companies.
Estimated impact: This provision has a significant financial impact on drug manufacturers by protecting their existing Medicaid rebate obligations from being negatively affected by the new subscription program's pricing.
Grants the Secretary of Health and Human Services the authority to delay the implementation of eliminating Medicare Part D cost-sharing for hepatitis C direct-acting antivirals from plan year 2028 to plan year 2029 if it is determined that implementation for 2028 is not feasible.
Section 7(b)(B)
Why it matters:This is a common legislative practice to provide administrative flexibility for complex program changes, acknowledging that federal agencies may need more time to implement new rules and systems. It's a practical safeguard.
Case for: Proponents argue this provides essential administrative flexibility, recognizing the complexity of updating Medicare Part D systems and ensuring a smooth transition for beneficiaries and plans. It prevents rushed implementation that could lead to errors or disruptions.
Case against: Critics might argue that any delay in eliminating cost-sharing prolongs financial barriers for Medicare beneficiaries needing hepatitis C treatment. They might push for stricter deadlines or more resources to ensure timely implementation.
Estimated impact: The potential impact is a one-year delay in financial relief for Medicare Part D beneficiaries with hepatitis C, affecting their out-of-pocket costs for that year.