Section 1 Short title
This Act may be cited as the “Capping Prescription Costs Act of 2021”.
Capping Prescription Costs Act of 2021
A BILL
To limit cost sharing for prescription drugs, and for other purposes.
Sec. 2 Cap on prescription drug cost-sharing
Qualified health plans— Section 1302(c) of the Patient Protection and Affordable Care Act (42 U.S.C. 18022(c)) is amended—
in paragraph (3)(A)(i), by inserting “, including cost-sharing with respect to prescription drugs covered by the plan” after “charges”; and
by adding at the end the following:
“(5) Prescription drug cost-sharing
“(A) 2023—For plan years beginning in 2023, the cost-sharing incurred under a health plan with respect to prescription drugs covered by the plan shall not exceed $250 per month for each enrolled individual, or $500 for each family.
“(B) 2024 and later
“(i) In general—In the case of any plan year beginning in a calendar year after 2023, the limitation under this paragraph shall be equal to the applicable dollar amount under subparagraph (A) for plan years beginning in 2023, increased by an amount equal to the product of that amount and the medical care component of the consumer price index for all urban consumers (as published by the Bureau of Labor Statistics) for that year.
“(ii) Adjustment to amount—If the amount of any increase under clause (i) is not a multiple of $5, such increase shall be rounded to the next lowest multiple of $5.”
Group health plans— Section 2707(b) of the Public Health Service Act (42 U.S.C. 300gg–6(b)) is amended—
by striking “annual”; and
by striking “paragraph (1) of section 1302(c)” and inserting “paragraphs (1) and (5) of section 1302(c) of the Patient Protection and Affordable Care Act”.
Effective date— The amendments made by subsections (a) and (b) shall take effect with respect to plans beginning after December 31, 2022.