The document summarizes key topics from ExLPharma's annual patient assistance programs conference, including implications of US health care reform proposals. Proposed reforms around expanding Medicaid eligibility, establishing health insurance exchanges, and closing the Medicare Part D "donut hole" could impact existing industry patient assistance programs by reducing the uninsured population and affecting cost-sharing responsibilities. Manufacturers may need to modify programs, increase support services to help patients navigate new coverage options, and coordinate more with public health programs and exchange navigators. The growing underinsured population also presents ongoing challenges requiring innovative program characteristics and operational improvements.