HR2553119th CongressWALLET

Capping Prescription Costs Act of 2025

Sponsored By: Representative Rep. Horsford, Steven [D-NV-4]

Introduced

Summary

This bill would impose uniform caps on prescription drug cost-sharing across private health plans. It sets fixed annual limits and ties future increases to the medical care component of the Consumer Price Index for All Urban Consumers so caps rise with medical inflation.

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Bill Overview

Analyzed Economic Effects

2 provisions identified: 2 benefits, 0 costs, 0 mixed.

New caps on drug costs for marketplace plans

If you have an ACA marketplace plan, your out-of-pocket prescription drug costs would be capped at $2,000 per person and $4,000 per family in 2026. For plan years after 2026, the caps would rise with the medical care component of the CPI-U and be rounded down to the next lowest multiple of $5. Insurers would also have to count drug copays and coinsurance in plan charges, which would help enforce these limits. These rules would apply to plan years beginning on or after January 1, 2026.

Employer plans would cap drug costs

If you get coverage through an employer, your plan would have to cap annual prescription costs at $2,000 per person and $4,000 per family in 2026. For later years, the caps would rise with the medical care component of the CPI-U and be rounded down to the next lowest multiple of $5. This would apply to both self-funded and fully insured group plans. The requirement would start for plan years that begin on or after January 1, 2026.

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Sponsors & CoSponsors

Sponsor

Rep. Horsford, Steven [D-NV-4]

NV • D

Cosponsors

  • Rep. Figures, Shomari [D-AL-2]

    AL • D

    Sponsored 4/1/2025

  • Rep. Stansbury, Melanie Ann [D-NM-1]

    NM • D

    Sponsored 4/1/2025

  • Rep. Johnson, Henry C. "Hank," Jr. [D-GA-4]

    GA • D

    Sponsored 4/1/2025

  • Rep. Waters, Maxine [D-CA-43]

    CA • D

    Sponsored 4/1/2025

  • Rep. Cherfilus-McCormick, Sheila [D-FL-20]

    FL • D

    Sponsored 4/1/2025

  • Rep. Hayes, Jahana [D-CT-5]

    CT • D

    Sponsored 4/1/2025

  • Rep. Thompson, Bennie G. [D-MS-2]

    MS • D

    Sponsored 4/1/2025

  • Del. Norton, Eleanor Holmes [D-DC-At Large]

    DC • D

    Sponsored 4/1/2025

  • Rep. Vasquez, Gabe [D-NM-2]

    NM • D

    Sponsored 3/12/2026

Roll Call Votes

No roll call votes available for this bill.

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