Bill · S. 529· Senate(119-S-529)
Capping Prescription Costs Act of 2025
- Introduced
- 2/11/2025
- Last activity
- 2/11/2025 — Read twice and referred to the Committee on Health, Education, Labor, and Pensions.
- Sponsored by
- Raphael Warnock
- Cosponsors
- - 13 - 0
- Introduced
- In Committee
What this bill would do
The Capping Prescription Costs Act of 2025 aims to limit the amount people have to pay out-of-pocket for prescription drugs. Under this bill, cost-sharing for prescription drugs covered by a health plan would be capped at $2,000 per year for individuals and $4,000 per year for families starting in 2026. For years after 2026, these limits would be adjusted annually based on the medical care component of the consumer price index. These limits would apply to Qualified Health Plans, as well as Group Health Plans. The changes are set to take effect for plan years beginning on or after January 1, 2026.
Yes· 3 of 8
Does this lower the price of prescription medicines?+7
The bill limits out-of-pocket cost-sharing for prescription drugs to $2,000 for individuals and $4,000 for families.
Would households on low incomes be better off under this?+6
The cap on prescription drug spending helps protect low-income households from high medical costs.
Would people over 65 be better off under this?+5
Capping prescription drug costs provides significant financial protection for seniors on fixed incomes.
The opposite
No question was scored the opposite.
Who it would affect, and how
Potential Positive Impacts for People
-
Predictable Out-of-Pocket Costs: For those with Qualified Health Plans, the bill sets a maximum limit on what they must pay for prescription drugs. Specifically, for plan years beginning in 2026, the cost-sharing cannot exceed $2,000 per year for an individual or $4,000 per year for a family (Section 2(a)(1)).
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Inflation-Adjusted Protections: To keep up with rising costs, the cap on prescription drug spending will be adjusted annually starting in 2027. The limit will increase based on the medical care component of the consumer price index for all urban consumers (Section 2(a)(1)(B)(i)).
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Broad Coverage for Group Plans: The bill extends these cost-sharing limitations to group health plans and health insurance issuers offering group health insurance coverage (Section 2(b)(1) and Section 2(b)(2)(A)).
Potential Negative Impacts for People
- Rounding Down of Increases: When adjusting the cap for inflation each year, if the increase is not a multiple of $5, the amount must be rounded down to the next lowest multiple of $5 (Section 2(a)(1)(B)(ii)).
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 Retirees+5Good For Seniors+5
- Healthcare
- Reduces Prescription Drug Costs+7Increases Affordable Care Act Support+5Improves Healthcare Access+4
- Social Issues And Justice
- Improves Poverty Reduction+3
- 8/1/2025
- 1 Cosponsor added.
- 4/1/2025
- 2 Cosponsors added.
- 2/11/2025
- Read twice and referred to the Committee on Health, Education, Labor, and Pensions.
- 10 Cosponsors added.
- Introduced in Senate
One bill Congress.gov lists as related to this one — companions in the other chamber, earlier versions, and bills this one absorbed or was folded into.
Angela AlsobrooksDemocrat · Maryland
Tammy BaldwinDemocrat · Wisconsin
Richard BlumenthalDemocrat · Connecticut
Cory BookerDemocrat · New Jersey
John FettermanDemocrat · Pennsylvania
Kirsten GillibrandDemocrat · New York
Ruben GallegoDemocrat · Arizona
Martin HeinrichDemocrat · New Mexico
Amy KlobucharDemocrat · Minnesota
Andy KimDemocrat · New Jersey
Ben LujánDemocrat · New Mexico
Patty MurrayDemocrat · Washington
Peter WelchDemocrat · Vermont