Bill · H.R. 5197· House(119-HR-5197)
Protect Beneficiaries from Middlemen Act
- Introduced
- 9/8/2025
- Last activity
- 9/8/2025 — Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
- Sponsored by
- Nicole Malliotakis
- Cosponsors
- None
- Introduced
- In Committee
What this bill would do
This bill, titled the "Protect Beneficiaries from Middlemen Act," seeks to amend the Social Security Act regarding Medicare Part D. It aims to limit cost sharing for covered drugs dispensed by a pharmacy. For plan years beginning on or after January 1, 2027, cost sharing for a month's supply of a drug cannot exceed the average net price or the applicable cash price, whichever is lower. This limitation also applies to copayments for low-income individuals. Additionally, the bill requires the Comptroller General to submit a report to Congress by January 1, 2029, regarding compliance and enforcement.
Yes· 3 of 12
Would people over 65 be better off under this?+8
The bill specifically reduces out-of-pocket expenses for Medicare beneficiaries who are primarily seniors.
Would retired people be better off under this?+8
The bill lowers drug costs specifically for those enrolled in Medicare Part D, which is a primary coverage for retirees.
Does this lower the price of prescription medicines?+8
The bill mandates that cost sharing for a month's supply of a covered Part D drug cannot exceed the average net price or the applicable cash price.
The opposite
No question was scored the opposite.
Who it would affect, and how
Potential Positive Impacts for People
-
Lower Drug Costs for Medicare Beneficiaries: Under Section 2(a)(1)(A), the bill limits the cost sharing for a month's supply of a covered Part D drug to the average net price or the applicable cash price, whichever is lower. This could reduce the amount people pay out-of-pocket for their medications.
-
Protection for Low-Income Individuals: Section 2(b) amends the Social Security Act to ensure that copayment amounts for low-income individuals do not exceed the new cost-sharing limits established in the bill.
Potential Negative Impacts for People
- No specific negative impacts are mentioned in the text provided.
Groups and Interests Ranking
Every group the model scored this bill for, from -10 to +10. Hover a score for the reason it gave.
- Demographic And Interest Groups
- Good For Retirees+8Good For Seniors+8Good For Low Income Households+6Good For People With Disabilities+4Good For Veterans+4Good For Middle Class Households+3
- Healthcare
- Reduces Prescription Drug Costs+8Improves Healthcare Access+3Increases Medicare Funding+3
- Social Issues And Justice
- Improves Social Security+4Improves Poverty Reduction+3
- Governance And Ideology
- Improves Government Transparency+2
- 9/8/2025
- Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
- Introduced in House