# 119-s-4886: Medicare Cost Cap Act of 2026

119-s-4886, Medicare Cost Cap Act of 2026, is a 119th Congress bill sponsored by Sen. Blunt Rochester, Lisa [D-DE] (D-DE); status introduced; PRIA reads it as touching household money (as of 2026-07-24).

- Canonical: https://policyrisk.com/legislation/119-s-4886
- As of: 2026-07-24
- Plain-text twin of the page above; the HTML and this file carry the same facts.

## Facts
- Bill: 119-s-4886
- Congress: 119
- Title: Medicare Cost Cap Act of 2026
- Status: introduced
- Introduced: 2026-06-24
- Sponsor: Sen. Blunt Rochester, Lisa [D-DE] (D-DE)
- Cosponsors: 16
- Policy area: Health
- Touches household money: yes
- Last recorded action: 2026-07-24

## Summary

**This bill would cap annual out-of-pocket Medicare fee-for-service costs at $5,000 in 2028.** It would also align and expand low-income Medicare assistance rules so more people qualify for help starting in 2028. - Medicare fee-for-service beneficiaries: Once an individual’s Part A and Part B cost-sharing hits the $5,000 limit in 2028 the bill would stop additional OOP charges for covered Part A and B services for the rest of that year. The limit would rise each year based on Part A and B per capita spending growth and be announced annually. - Low-income Medicare beneficiaries: The bill would remove the resource test for key subsidy programs and raise income eligibility to 200 percent of the federal poverty line beginning January 1, 2028. It would also align rules so eligibility for one program can trigger eligibility for the other and speed enrollment by using Social Security Administration data. - Providers and physicians: Providers could not impose balance bills once the annual limit is reached and physicians must be notified when a patient hits the cap to encourage assignment-based payments for the remainder of the year.

## Cosponsors (16)

- Sen. Wyden, Ron [D-OR] (D-OR), 2026-06-24T00:00:00.000Z
- Sen. Schumer, Charles E. [D-NY] (D-NY), 2026-06-24T00:00:00.000Z
- Sen. Merkley, Jeff [D-OR] (D-OR), 2026-06-24T00:00:00.000Z
- Sen. Luján, Ben Ray [D-NM] (D-NM), 2026-06-24T00:00:00.000Z
- Sen. Markey, Edward J. [D-MA] (D-MA), 2026-06-24T00:00:00.000Z
- Sen. Warren, Elizabeth [D-MA] (D-MA), 2026-06-24T00:00:00.000Z
- Sen. Reed, Jack [D-RI] (D-RI), 2026-06-24T00:00:00.000Z
- Sen. Duckworth, Tammy [D-IL] (D-IL), 2026-06-24T00:00:00.000Z
- Sen. Welch, Peter [D-VT] (D-VT), 2026-06-24T00:00:00.000Z
- Sen. Booker, Cory A. [D-NJ] (D-NJ), 2026-06-24T00:00:00.000Z
- Sen. Gillibrand, Kirsten E. [D-NY] (D-NY), 2026-06-24T00:00:00.000Z
- Sen. Padilla, Alex [D-CA] (D-CA), 2026-06-24T00:00:00.000Z
- Sen. Van Hollen, Chris [D-MD] (D-MD), 2026-06-24T00:00:00.000Z
- Sen. Murray, Patty [D-WA] (D-WA), 2026-06-24T00:00:00.000Z
- Sen. Schiff, Adam B. [D-CA] (D-CA), 2026-07-22T00:00:00.000Z
- Sen. Blumenthal, Richard [D-CT] (D-CT), 2026-07-22T00:00:00.000Z

## Provisions PRIA read

- Yearly Medicare cost cap for beneficiaries: benefit, high. This bill would create a yearly out-of-pocket limit for traditional Medicare (Parts A and B) beneficiaries. In 2028 the limit would be $5,000. After 2028 the Secretary would raise the limit each year by the annual percent change in average per-person Parts A and B spending (12-month period ending e…

## Related bills

- 119-s-5066: Health Equity and Accountability Act of 2026
- 119-s-2823: FAMILY Act
- 119-s-51: Washington, D.C. Admission Act
- 119-s-5108: Right to IVF Act of 2026
- 119-s-1503: Equality Act
- 119-s-852: Richard L. Trumka Protecting the Right to Organize Act of 2025

## Sources
- [119-s-4886 on Congress.gov](https://www.congress.gov/bill/119th-congress/senate-bill/4886)

## Related
- [119-s-5066: Health Equity and Accountability Act of 2026](https://policyrisk.com/legislation/119-s-5066)
- [119-s-2823: FAMILY Act](https://policyrisk.com/legislation/119-s-2823)
- [119-s-51: Washington, D.C. Admission Act](https://policyrisk.com/legislation/119-s-51)
- [119-s-5108: Right to IVF Act of 2026](https://policyrisk.com/legislation/119-s-5108)
- [119-s-1503: Equality Act](https://policyrisk.com/legislation/119-s-1503)
- [119-s-852: Richard L. Trumka Protecting the Right to Organize Act of 2025](https://policyrisk.com/legislation/119-s-852)
- [All bills in Congress](https://policyrisk.com/legislation)

Source: PRIA, https://policyrisk.com/legislation/119-s-4886 (as of 2026-07-24).