Cutting Copays Act
Sponsored By: Representative McGarvey, Morgan [D-KY-3]
Introduced
Summary
Cuts copays for low-income Medicare Part D enrollees. The Cutting Copays Act would set a phased, year-by-year schedule that lowers out-of-pocket drug costs for low-income Part D beneficiaries, moves many generics to $0 in 2026, and ties later increases to the Consumer Price Index.
Show full summary
- Low-income Part D enrollees who use generics: Would face a cap of no more than $1 for many generics before 2026 and a $0 copay in plan year 2026.
- Low-income Part D enrollees who use non-generic drugs: Would see a cap of $3 before 2026, then a new 2026 dollar level for those drugs that increases each year by the annual Consumer Price Index (U.S. city average, all items).
- Medicare plans and administrators: Would apply the new dollar caps within the existing Part D cost-sharing reduction framework and use the statute’s current clause (iii) copayment amounts as the comparison point when the statute refers to lower amounts.
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Bill Overview
Analyzed Economic Effects
1 provisions identified: 1 benefits, 0 costs, 0 mixed.
Lower drug copays for low-income Medicare
If enacted, low-income Medicare Part D enrollees would pay less at the pharmacy. Before 2026, copays would be capped at $1 for a generic or preferred multiple-source drug, and $3 for other drugs. If your current low-income copay is lower, you would keep the lower amount. In 2026, generics would be $0. Other drugs would use the same dollar cap used in 2023. Starting in 2027, the prior year’s cap would adjust each year by the September CPI-U.
Sponsors & CoSponsors
Sponsor
McGarvey, Morgan [D-KY-3]
KY • D
Cosponsors
Bilirakis
FL • R
Sponsored 6/25/2025
Roll Call Votes
No roll call votes available for this bill.
View on Congress.gov