H.R.2553 - Capping Prescription Costs Act of 2025 (119th Congress)
Summary
H.R.2553, the "Capping Prescription Costs Act of 2025," aims to limit cost-sharing for prescription drugs under qualified health plans and group health plans. The bill amends the Patient Protection and Affordable Care Act, the Public Health Service Act, the Employee Retirement Income Security Act, and the Internal Revenue Code of 1986. It sets a cost-sharing limit of $2,000 per individual and $4,000 per family for prescription drugs starting in 2026, with adjustments for inflation in subsequent years.
Expected Effects
The primary effect of this bill would be to reduce out-of-pocket expenses for prescription drugs for many Americans with health insurance. This could lead to increased access to necessary medications and improved health outcomes. The bill also introduces a mechanism for adjusting the cost-sharing limits based on the Consumer Price Index, ensuring that the cap keeps pace with inflation.
Potential Benefits
- Reduced out-of-pocket costs for prescription drugs, making medications more affordable.
- Increased access to necessary medications, potentially improving health outcomes.
- Financial relief for individuals and families struggling to afford prescription drugs.
- Predictable cost-sharing limits, allowing for better budgeting and financial planning.
- Inflation adjustments to the cost-sharing limits, maintaining the real value of the cap over time.
Potential Disadvantages
- Potential increase in premiums for health insurance plans to offset the reduced cost-sharing.
- Possible reduction in the range of prescription drugs covered by health plans.
- Increased government spending, potentially contributing to the national debt.
- Complexity in implementing and administering the cost-sharing limits.
- Potential for unintended consequences, such as increased utilization of prescription drugs and higher overall healthcare costs.
Most Disadvantaged Areas:
Constitutional Alignment
The bill appears to align with the general welfare clause of the Constitution, as it aims to improve public health by making prescription drugs more affordable. However, the Constitution does not explicitly address healthcare or prescription drug costs. The bill's impact on interstate commerce, through regulation of health insurance plans, could also be considered under the Commerce Clause (Article I, Section 8).
Impact Assessment: Things You Care About ⓘ
This action has been evaluated across 19 key areas that matter to you. Scores range from 1 (highly disadvantageous) to 5 (highly beneficial).