This bill would cap how much individuals and families have to pay out-of-pocket for prescription drugs each year. Starting in 2026, people enrolled in health plans would pay no more than $2,000 annually for prescription drugs, while families would be capped at $4,000 per year. The cap would apply to qualified health plans under the Affordable Care Act as well as employer-sponsored group health plans. Beginning in 2027, these dollar limits would increase each year based on growth in medical care costs, adjusted to the nearest five-dollar increment. The legislation was introduced in July 2024 and would take effect for health plans beginning after December 31, 2025.
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