Bill · H.R. 6171· House(119-HR-6171)
ACA Copay CAP Act of 2025
- Introduced
- 11/20/2025
- Last activity
- 11/20/2025 — Referred to the House Committee on Energy and Commerce.
- Sponsored by
- Jake Auchincloss
- Cosponsors
- None
- Introduced
- In Committee
What this bill would do
This bill, known as the ``ACA Copay Cost and Affordability for Patients Act of 2025'', aims to amend the Patient Protection and Affordable Care Act. It seeks to establish a specific limit on how much people have to pay out-of-pocket for prescription drugs under a health plan. For self-only coverage starting in 2027, this limit is set at $2,000. For coverage involving more than one person, the limit is twice that amount. The bill includes a method to adjust these limits in future years based on premium adjustment percentages.
Yes· 3 of 7
Does this lower the price of prescription medicines?+7
The bill establishes a cap on annual out-of-pocket spending for prescription drugs.
Would households on low incomes be better off under this?+6
Capping annual prescription drug costs provides significant financial relief to low-income families.
Would people over 65 be better off under this?+5
The cap on prescription drug costs provides financial predictability for seniors on health plans.
The opposite
No question was scored the opposite.
Who it would affect, and how
Potential Positive Impacts for People
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Caps annual drug costs: This provision limits the amount of money a person has to pay for prescription drugs in a plan year (Section 2(a)(1)). This ensures that individuals have a predictable maximum amount they will spend on their medications.
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Limits out-of-pocket expenses for families: For coverage that is not just for one person, the bill sets a limit at twice the amount of the self-only limit (Section 2(a)(1)(B)(ii)). This provides a financial ceiling for those with multi-person health plans.
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Adjusts for inflation/cost changes: The bill allows the $2,000 limit for self-only coverage to increase in subsequent years based on the premium adjustment percentage (Section 2(a)(1)(B)(i)(II)). This helps keep the cap relevant as costs change over time.
Potential Negative Impacts for People
- No specific negative impacts are detailed in the provided text: The provided text focuses exclusively on establishing the limits and the mechanics for adjusting those limits.
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 Low Income Households+6Good For Middle Class Households+5Good For Seniors+5Good For People With Disabilities+4
- Healthcare
- Reduces Prescription Drug Costs+7Increases Affordable Care Act Support+5Improves Healthcare Access+4
- 11/20/2025
- Referred to the House Committee on Energy and Commerce.
- Introduced in House