Us Congress 2025-2026 Regular Session

Us Congress House Bill HB2553 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1	I
2	2	119THCONGRESS
3	3	1
4	4	STSESSION H. R. 2553
5	5	To limit cost-sharing for prescription drugs, and for other purposes.
6	6	IN THE HOUSE OF REPRESENTATIVES
7	7	APRIL1, 2025
8	8	Mr. H
9	9	ORSFORD(for himself, Mr. FIGURES, Ms. STANSBURY, Mr. JOHNSON
10	10	of Georgia, Ms. W
11	11	ATERS, Mrs. CHERFILUS-MCCORMICK, Mrs. HAYES,
12	12	Mr. T
13	13	HOMPSONof Mississippi, and Ms. NORTON) introduced the fol-
14	14	lowing bill; which was referred to the Committee on Energy and Com-
15	15	merce, and in addition to the Committees on Education and Workforce,
16	16	and Ways and Means, for a period to be subsequently determined by the
17	17	Speaker, in each case for consideration of such provisions as fall within
18	18	the jurisdiction of the committee concerned
19	19	A BILL
20	20	To limit cost-sharing for prescription drugs, and for other
21	21	purposes.
22	22	Be it enacted by the Senate and House of Representa-1
23	23	tives of the United States of America in Congress assembled, 2
24	24	SECTION 1. SHORT TITLE. 3
25	25	This Act may be cited as the ‘‘Capping Prescription 4
26	26	Costs Act of 2025’’. 5
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29	29	•HR 2553 IH
30	30	SEC. 2. CAP ON PRESCRIPTION DRUG COST-SHARING. 1
31	31	(a) Q
32	32	UALIFIEDHEALTHPLANS.—Section 1302(c) of 2
33	33	the Patient Protection and Affordable Care Act (42 3
34	34	U.S.C. 18022(c)) is amended— 4
35	35	(1) in paragraph (3)(A)(i), by inserting ‘‘, in-5
36	36	cluding cost-sharing with respect to prescription 6
37	37	drugs covered by the plan’’ after ‘‘charges’’; and 7
38	38	(2) by adding at the end the following: 8
39	39	‘‘(5) P
40	40	RESCRIPTION DRUG COST -SHARING.— 9
41	41	‘‘(A) 2026.—For plan years beginning in 10
42	42	2026, the cost-sharing incurred under a health 11
43	43	plan with respect to prescription drugs covered 12
44	44	by the plan shall not exceed $2,000 per year for 13
45	45	each enrolled individual, or $4,000 per year for 14
46	46	each family. 15
47	47	‘‘(B) 2027
48	48	AND LATER.— 16
49	49	‘‘(i) I
50	50	N GENERAL.—In the case of any 17
51	51	plan year beginning in a calendar year 18
52	52	after 2026, the limitation under this para-19
53	53	graph shall be equal to the applicable dol-20
54	54	lar amount under subparagraph (A) for 21
55	55	plan years beginning in 2026, increased by 22
56	56	an amount equal to the product of that 23
57	57	amount and the medical care component of 24
58	58	the consumer price index for all urban con-25
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61	61	•HR 2553 IH
62	62	sumers (as published by the Bureau of 1
63	63	Labor Statistics) for that year. 2
64	64	‘‘(ii) A
65	65	DJUSTMENT TO AMOUNT .—If 3
66	66	the amount of any increase under clause 4
67	67	(i) is not a multiple of $5, such increase 5
68	68	shall be rounded to the next lowest mul-6
69	69	tiple of $5.’’. 7
70	70	(b) G
71	71	ROUPHEALTHPLANS.— 8
72	72	(1) P
73	73	UBLIC HEALTH SERVICE ACT .—Part D of 9
74	74	title XXVII of the Public Health Service Act (42 10
75	75	U.S.C. 300gg–111 et seq.) is amended by inserting 11
76	76	after section 2799A–5 (42 U.S.C. 300gg–115) the 12
77	77	following: 13
78	78	‘‘SEC. 2799A–6. CAP ON PRESCRIPTION DRUG COST-SHAR-14
79	79	ING FOR GROUP HEALTH PLANS. 15
80	80	‘‘A group health plan and health insurance issuer of-16
81	81	fering group health insurance coverage shall ensure that 17
82	82	any cost-sharing imposed under the plan or coverage with 18
83	83	respect to prescription drugs covered by the plan or cov-19
84	84	erage does not exceed the limitations provided for under 20
85	85	paragraph (5) of section 1302(c) of the Patient Protection 21
86	86	and Affordable Care Act.’’. 22
87	87	(2) E
88	88	MPLOYEE RETIREMENT INCOME SECURITY 23
89	89	ACT.— 24
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92	92	•HR 2553 IH
93	93	(A) IN GENERAL.—Subpart B of part 7 of 1
94	94	subtitle B of title I of the Employee Retirement 2
95	95	Income Security Act of 1974 (29 U.S.C. 1185 3
96	96	et seq.) is amended by inserting after section 4
97	97	720 (29 U.S.C. 1185i) the following: 5
98	98	‘‘SEC. 721. CAP ON PRESCRIPTION DRUG COST-SHARING. 6
99	99	‘‘A group health plan and health insurance issuer of-7
100	100	fering group health insurance coverage shall ensure that 8
101	101	any cost-sharing imposed under the plan or coverage with 9
102	102	respect to prescription drugs covered by the plan or cov-10
103	103	erage does not exceed the limitations provided for under 11
104	104	paragraph (5) of section 1302(c) of the Patient Protection 12
105	105	and Affordable Care Act.’’. 13
106	106	(B) C
107	107	LERICAL AMENDMENT .—The table of 14
108	108	contents in section 1 of the Employee Retire-15
109	109	ment Income Security Act of 1974 (29 U.S.C. 16
110	110	1001 note) is amended by inserting after the 17
111	111	item relating to section 720 the following: 18
112	112	‘‘Sec. 721. Cap on prescription drug cost-sharing.’’.
113	113	(3) INTERNAL REVENUE CODE OF 1986 .— 19
114	114	(A) I
115	115	N GENERAL.—Subchapter B of chap-20
116	116	ter 100 of the Internal Revenue Code of 1986 21
117	117	is amended by inserting after section 9820 the 22
118	118	following: 23
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121	121	•HR 2553 IH
122	122	‘‘SEC. 9821. CAP ON PRESCRIPTION DRUG COST-SHARING. 1
123	123	‘‘A group health plan shall ensure that any cost-shar-2
124	124	ing imposed under the plan with respect to prescription 3
125	125	drugs covered by the plan does not exceed the limitations 4
126	126	provided for under paragraph (5) of section 1302(c) of 5
127	127	the Patient Protection and Affordable Care Act.’’. 6
128	128	(B) C
129	129	LERICAL AMENDMENT .—The table of 7
130	130	sections for subchapter B of chapter 100 of the 8
131	131	Internal Revenue Code of 1986 is amended by 9
132	132	inserting after the item relating to section 9820 10
133	133	the following: 11
134	134	‘‘Sec. 9821. Cap on prescription drug cost-sharing’’.
135	135	(c) EFFECTIVEDATE.—The amendments made by 12
136	136	subsections (a) and (b) shall take effect with respect to 13
137	137	plan years beginning on or after January 1, 2026. 14
138	138	Æ
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