S2617119th CongressWALLET

Reducing Drug Prices for Seniors Act.

Sponsored By: Senator Jacky Rosen

Introduced

Summary

Would base Medicare Part D coinsurance on a drug's negotiated net price rather than its list price. It ties patient cost sharing to the plan's negotiated price after manufacturer concessions, using the prior year's Detailed DIR Report to set that net price for many formulary drugs within the deductible-to-out-of-pocket band.

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Bill Overview

Analyzed Economic Effects

1 provisions identified: 1 benefits, 0 costs, 0 mixed.

New Medicare drug coinsurance rule

This bill would require Medicare Part D coinsurance to be based on a drug's net price when that net price is lower than the list price. It would apply for plan years beginning on January 1, 2026. It would only help drugs on your plan's formulary that use coinsurance, not copayments. It would only apply to costs above your annual deductible and below your annual out-of-pocket limit. The bill would use the plan's Detailed DIR Report from the previous plan year to set the net price. It would not apply to drugs listed in paragraphs (8) or (9).

Sponsors & CoSponsors

Sponsor

Jacky Rosen

NV • D

Cosponsors

  • John Cornyn

    TX • R

    Sponsored 7/31/2025

Roll Call Votes

No roll call votes available for this bill.

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