H.R. 8270 — Every Dollar Counts Act of 2026

This section requires group health plans and health insurance issuers offering group or individual coverage to count enrollees' out-of-pocket expenditures for drugs—purchased without using plan benefits (e.g., to access a lower cash price)—toward applicable deductibles and out-of-pocket maximums, as if benefits had been applied. It makes conforming amendments to Medicaid drug rebate calculations under the Social Security Act to exclude such price reductions from best price and average manufacturer price determinations. The requirements apply to plan years beginning on or after January 1, 2027.