​
A bipartisan pair of House members are introducing legislation aimed at treating millions of Americans of a deadly-but-curable liver disease, the culmination of a yearslong push from public health advocates.

The bill, sponsored by Reps. Mariannette Miller-Meeks, R-Iowa and Diana DeGette, D-Colo., would create a national hepatitis C elimination program to expand testing and treatment especially for people least likely to access it, including those who are incarcerated, uninsured, low-income, or receiving care through the Indian Health Service.

The legislation would also direct the federal government to enter into five-year subscription agreements with at least one drug manufacturer to purchase unlimited hepatitis C treatments at a fixed price. That could make a big difference in expanding access to the drug, which can cost tens of thousands of dollars per course of treatment.

“Hepatitis C is beatable. We have the tools to eliminate it, and this bill puts them within reach of the Americans who need them most,” Miller-Meeks said in a statement.

An estimated 2.2 million to 4 million adults in the U.S. have hepatitis C. Because the disease often has no early symptoms, only about half are aware they are infected.

Hepatitis C spreads primarily through exposure to infected blood, most commonly through sharing needles or other equipment used to inject drugs. Among those who are diagnosed, just one-third receive timely treatment. Left untreated, hepatitis C can lead to serious complications, including liver damage, cancer, and death.

The legislation would appropriate $5.5 billion in mandatory funds for the subscription purchase program, which would provide hepatitis C drugs to underserved, uninsured and other eligible patients. It would eliminate cost-sharing and prior authorization requirements for people who receive hepatitis C treatment through the program, as well as cost sharing for Medicare Part D beneficiaries through 2032.

It would also award nearly $4.3 billion worth of grants to states, community health centers, tribal health programs, correctional facilities and other organizations.

Sponsors say the measure would ultimately save the federal government $6.6 billion over ten years by reducing the long-term costs of treating the effects of the disease, though sponsors are still awaiting an official score from the Congressional Budget Office.

The bill is cosponsored by Reps. Hank Johnson, D-Ga., and Don Bacon, R-Neb.

Johnson, who has disclosed that he had hepatitis C but is free of the disease since undergoing treatment, said in a statement he hopes to raise awareness of the “silent killer” so that “others at risk can get tested and treated.”

Several countries are on the way to eliminating hepatitis C as a public health threat by 2030 following a goal established by the World Health Organization after a cure hit the market more than a decade ago. 

While the U.S. signed onto that goal, its progress has trailed behind other countries like England, which has funded a national plan that focuses on expanding free access to testing and treatment.

Under the U.S. health care system, access can vary based on where a person lives, what type of insurance they have — if they have any — and whether they are incarcerated or facing challenges like homelessness or drug use.

The high price tag for the drug in the U.S. has also led state Medicaid programs, insurers and correctional facilities to impose restrictions that limit access to treatment.

The bill’s sponsors will likely try to tack the legislation onto a must pass, year-end spending bill.

Miller-Meeks and DeGette are members of the Energy and Commerce Health Subcommittee, which has jurisdiction over the bill. DeGette is the panel’s top Democrat.

The bill is similar to one sponsored by Senate Health, Education, Labor and Pensions Chairman Bill Cassidy, R-La., and cosponsored by Sen. Chris Van Hollen, D-Md., except that language preventing immigrants from accessing the medication under the program in the Senate version does not appear in the House text.

That language had been a non-starter for House Democrats, who noted that hepatitis C is an infectious disease that can spread regardless of immigration status.

The Senate bill has yet to receive hearings or a vote in committee.

DeGette and Cassidy are leaving Congress after losing their primaries, putting more pressure on them to cement their legacies.

Miller-Meeks, a physician and former director of Iowa’s public health department, is a perennial Democratic target every two years. She won her 2024 race by just 799 votes, a 0.2 percentage-point margin. Inside Elections with Nathan L. Gonzales rates her 2026 race a Toss-up.

​