To amend the Patient Protection and Affordable Care Act to establish an out-of-pocket limit on spending for prescription drugs.
Analysis under review: This bill has generated analysis that may be too generic or incomplete. Clause-level evidence remains available below.
Summary
What This Bill Does
Caps annual out-of-pocket prescription drug cost sharing in ACA health plans beginning in 2027.
Who Benefits and How
Patients in ACA plans gain a federal limit on annual prescription drug cost sharing, reducing exposure to high drug out-of-pocket costs.
Who Bears the Burden and How
Health plan issuers must absorb or redesign benefits around the new prescription drug cost-sharing cap.
Key Provisions
- Creates a $2,000 self-only annual prescription drug cost-sharing cap for 2027, indexed thereafter.
- Sets the non-self-only cap at twice the self-only amount.
- Applies the cap through ACA essential health benefit and cost-sharing provisions.
Evidence Chain:
This summary is generated from the full bill text using AI analysis. Expand "Detailed Analysis" below for identified beneficiaries/burden bearers.
At a Glance
What This Bill Does
Caps annual out-of-pocket prescription drug cost sharing in ACA health plans beginning in 2027.
Key Policy Areas
Healthcare, Finance, Government Operations
Primary Purpose
Caps annual out-of-pocket prescription drug cost sharing in ACA health plans beginning in 2027.
Policy Domains
Main Provisions
Identified Gains
Contextual inference, no direct clause citation- Patients enrolled in ACA plans who use prescription drugs
Contextual inference, no direct clause citation
Identified Costs
Contextual inference, no direct clause citation- ACA health plan issuers
Contextual inference, no direct clause citation
Legislative Progress
IntroducedMr. Auchincloss introduced the following bill; which was referred to …
Stakeholder Effects
cui bono?How this legislation distributes effects. Mention counts reflect frequency, not effect magnitude.
Patients enrolled in ACA plans who use prescription drugs
Bill Structure & Actor Mappings
Who is "The Secretary" in each section?
We use a combination of our own taxonomy and classification in addition to large language models to assess meaning and potential beneficiaries. High confidence means strong textual evidence. Always verify with the original bill text.
Learn more about our methodology