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Senate Bill 3194
115th Congress(2017-2018)
Capping Prescription Costs Act of 2018
Introduced
Introduced
Introduced in Senate on Jul 11, 2018
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Introduced in Senate 
Jul 11, 2018
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Introduced in Senate(Jul 11, 2018)
Jul 11, 2018
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S. 3194 (Introduced-in-Senate)


115th CONGRESS
2d Session
S. 3194


To amend the Patient Protection and Affordable Care Act to cap prescription drug cost-sharing, and for other purposes.

IN THE SENATE OF THE UNITED STATES

July 11, 2018

Ms. Warren (for herself, Mr. Nelson, Mr. Wyden, Mrs. Murray, Mr. Whitehouse, Ms. Smith, Mr. Leahy, Ms. Hassan, Ms. Baldwin, Mr. Durbin, Mrs. Shaheen, Mr. Blumenthal, Mr. Heinrich, Mr. Udall, Mrs. Gillibrand, Mr. Reed, and Mr. Merkley) introduced the following bill; which was read twice and referred to the Committee on Health, Education, Labor, and Pensions

A BILL

To amend the Patient Protection and Affordable Care Act to cap prescription drug cost-sharing, and for other purposes.

Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,

SECTION 1. Short title.

This Act may be cited as the “Capping Prescription Costs Act of 2018”.

SEC. 2. Cap on prescription drug cost-sharing.

(a) Qualified health plans.—Section 1302(c) of the Patient Protection and Affordable Care Act (42 U.S.C. 18022(c)) is amended—

(1) in paragraph (3)(A)(i), by inserting “, including cost-sharing with respect to prescription drugs covered by the plan” after “charges”; and

(2) by adding at the end the following:

“(5) PRESCRIPTION DRUG COST-SHARING.—

“(A) 2020.—For plan years beginning in 2020, 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) 2021 AND LATER.—

“(i) IN GENERAL.—In the case of any plan year beginning in a calendar year after 2020, the limitation under this paragraph shall be equal to the applicable dollar amount under subparagraph (A) for plan years beginning in 2020, 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.”.

(b) Group health plans.—Section 2707(b) of the Public Health Service Act (42 U.S.C. 300gg–6(b)) is amended—

(1) by striking “annual”; and

(2) 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”.

(c) Effective date.—The amendments made by subsections (a) and (b) shall take effect with respect to plans beginning after December 31, 2019.