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119-hr-2553119th CongressWALLET
Capping Prescription Costs Act of 2025
Sponsored By: Representative 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.
Sponsors & CoSponsors
Sponsor
Horsford, Steven [D-NV-4]
NV • D
Cosponsors
Rep. Figures, Shomari [D-AL-2]
AL • D
Sponsored 4/1/2025
Rep. Stansbury, Melanie A. [D-NM-1]
NM • D
Sponsored 4/1/2025
Rep. Johnson, Henry C. "Hank" [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.
View on Congress.gov