PAN disappointed HHS 2026 proposed rule doesn’t address copay accumulators
Today, the PAN Foundation expressed disappointment that the 2026 Notice of Benefit and Payment Parameters (NBPP) proposed rule does not address copay accumulators, which are programs implemented by insurance companies that affect how copay assistance is applied to deductible and out-of-pocket costs.
Each year, the Centers for Medicare & Medicaid Services (CMS) propose, review, and eventually finalize the rules and regulations that guide the operation of the federal healthcare Marketplace. Earlier this month, the U.S. Department of Health and Human Services (HHS) released the 2026 NBPP proposed rule.
“It is discouraging to once again see the administration miss an opportunity to protect patients from harmful copay accumulator policies,” said PAN President and CEO Kevin L. Hagan. “These programs disproportionately impact patients with low incomes who need expensive medications. We continue to push for federal regulations and legislation that ensure all copay assistance counts toward a patient’s annual deductible.”
Many patients with serious, chronic, or rare health conditions turn to financial assistance programs, like PAN, to afford their out-of-pocket prescription medication costs. These financial assistance programs serve as a critical lifeline for thousands of people each year. However, copay accumulator programs used by commercial health plans prevent patients from using this financial assistance to count toward their deductibles or maximum out-of-pocket limit. The use of copay accumulator programs results in a much larger overall out-of-pocket financial burden for many and must be addressed.
About the PAN Foundation
As a leading charitable foundation and healthcare advocacy organization, the PAN Foundation is dedicated to accelerating access to treatment for those who need it most and empowering patients on their healthcare journeys. We provide critical financial assistance for treatment costs, advocate for policy solutions that expand access to care, and deliver education on complex topics—all driven by our belief that everyone deserves access to affordable, equitable healthcare.
Since 2004, our financial assistance programs have helped more than 1.2 million people to start or stay on life-changing treatment. In addition, we’ve achieved major policy victories that increase access to care, mobilized patient advocates to call for change, and educated people nationwide on critical healthcare-related topics. We’re committed to working towards a future where equitable health outcomes are a reality for all. To learn more, visit panfoundation.org.