Mariannette Miller-Meeks (R-IA)
VA National Formulary Act of 2025
A Republican bill with no cosponsors
Last activity — Committee Hearings Held
In committee
Introduced and handed to a committee in the chamber it started in.
The committee holds it, and most bills are never heard from again. A hearing or a committee vote would be news; silence is the usual outcome, and it kills the bill without anyone voting against it.
Its path through Congress
- Introduced
- In Committee
What this bill would do
The VA National Formulary Act of 2025 aims to improve how the Department of Veterans Affairs manages its list of prescribed drugs and supplies. It establishes a national formulary that must be implemented uniformly across all medical facilities. The bill creates a Pharmacy and Therapeutics Committee to make evidence-based decisions on drug inclusions and exclusions. It also implements a standardized electronic system for clinicians to request drugs not found on the national list. Additionally, the act allows the Secretary to negotiate supplemental discounts and value-based purchasing agreements with manufacturers. Finally, it introduces a tiered copayment schedule to encourage the use of cost-effective medications.
Yes· 3 of 7
- Scored +7
Does this help veterans get medical care?
The bill enhances veteran care through a uniform national formulary, streamlined nonformulary request processes, and enhanced medication therapy management.
- Scored +6
Does this lower the price of prescription medicines?
The bill authorizes the Secretary to negotiate supplemental discounts and value-based agreements to reduce drug costs.
- Scored +6
Would veterans be better off under this, taking everything together?
The bill provides more consistent medication access and a structured appeals process for veterans.
The opposite
No question was scored the opposite.
Who it would affect, and how
Potential Positive Impacts for People
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Uniformity of Care: The national formulary will be implemented uniformly across all Department medical facilities, ensuring consistency in drug availability (Sec. 7385(b)(1)).
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Increased Transparency: The Secretary is required to communicate regularly with the public regarding formulary management and provide rationales for significant changes, such as removing a commonly used medication (Sec. 7385(c)).
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Efficient Drug Access: The establishment of a standardized electronic system for nonformulary requests aims to integrate with clinician workflows for faster service (Sec. 7387(a)).
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Prompt Clinical Decisions: The bill mandates that initial decisions on nonformulary drug requests be communicated to clinicians within 96 hours (Sec. 7387(b)).
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Portability of Approvals: If a drug is approved for a veteran, that approval remains valid even if the veteran moves to a different medical center or location within the Veterans Health Administration (Sec. 7387(d)).
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Enhanced Safety: The bill requires medication therapy management with a focus on polypharmacy and high-risk medications to identify inappropriate prescribing or drug duplication (Sec. 7388(b)).
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Cost Savings through Negotiation: The Secretary is authorized to negotiate additional discounts, rebates, and value-based agreements with manufacturers to provide net cost savings (Sec. 8130(a) and (b)).
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Veteran Input: The creation of a Veterans Formulary Advisory Committee allows front-line providers and stakeholders to provide feedback on proposed changes (Sec. 4(a) and (d)).
Potential Negative Impacts for People
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Local Formulary Restrictions: Individual medical centers or networks are generally prohibited from maintaining a local formulary that includes drugs not found on the national list (Sec. 7385(b)(2)).
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Increased Costs for Certain Medications: A tiered copayment schedule will result in higher copayments for brand-name drugs or drugs not included on the national formulary (Sec. 1722A(d)(2)).
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Potential Access Barriers: While waivers exist, the bill restricts the ability of local facilities to carry drugs that are not part of the national formulary unless specifically approved through a centralized review process (Sec. 7385(b)(2)).
Groups and Interests Ranking
Every group the model scored this bill for, from -10 to +10. Tap or hover a score for the reason it gave.
- Healthcare
- Does this help veterans get medical care? — The bill enhances veteran care through a uniform national formulary, streamlined nonformulary request processes, and enhanced medication therapy management. Does this lower the price of prescription medicines? — The bill authorizes the Secretary to negotiate supplemental discounts and value-based agreements to reduce drug costs.
- Governance And Ideology
- Does this make what the government does easier for the public to see? — The bill mandates public communication of formulary changes and annual reporting to Congress. Does this protect the right to fair treatment by the courts? — The bill establishes a formal tiered appeals process for nonformulary drug denials. Does this give the federal government more power? — The bill centralizes formulary decision-making at the national level, limiting local facility autonomy.
- Demographic And Interest Groups
- Would veterans be better off under this, taking everything together? — The bill provides more consistent medication access and a structured appeals process for veterans.
- National Security And Foreign Policy
- Does this increase the pay, pensions or support veterans receive? — The act improves the administration and consistency of drug availability for veterans.
- 5/20/2026
- Committee Hearings Held
- 3/18/2026
- Committee Hearings Held
- 12/10/2025
- Referred to the House Committee on Veterans' Affairs.
- Introduced in House