Expanding Drug Price Negotiation, Capping Out-of-Pocket Costs, and $35 Insulin.
This act significantly expands federal power to negotiate drug prices, applying the resulting lower costs to private insurance plans and increasing the number of negotiable drugs from 20 to 50. It establishes a new annual out-of-pocket spending cap for prescription drugs under private insurance, starting at $2,000 for individuals in 2027. Crucially, it mandates that cost-sharing for selected insulin products cannot exceed $35 per 30-day supply, aiming to reduce financial burdens on families.
Key points
$2,000 Annual Drug Spending Cap: Starting in 2027, private health plans must limit annual out-of-pocket spending on prescription drugs to $2,000 (for self-only coverage).
Insulin Cost Limit: Beginning in 2027, cost-sharing for selected insulin products is capped at $35 per 30-day supply, and deductibles cannot be applied.
Negotiation Expansion: The number of drugs subject to federal price negotiation increases to 50, and these negotiated prices will apply to private insurance markets.
Inflation Rebates: Drug manufacturers must pay rebates if their prices rise faster than inflation, with this requirement extended to the commercial (private) market.
Introduced
Citizen Poll