II 

116TH CONGRESS 

1ST SESSION S. 475 

To amend title XVIII of the Social Security Act to prevent catastrophic 

out-of-pocket spending on prescription drugs for seniors and individuals 

with disabilities. 

IN THE SENATE OF THE UNITED STATES 

FEBRUARY 13, 2019 

Mr. WYDEN (for himself, Mr. BENNET, Mr. CARDIN, Ms. KLOBUCHAR, Mr. 

MERKLEY, and Mr. WHITEHOUSE) introduced the following bill; which 

was read twice and referred to the Committee on Finance 

A BILL 

To amend title XVIII of the Social Security Act to prevent 

catastrophic out-of-pocket spending on prescription drugs 

for seniors and individuals with disabilities. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Reducing Existing 

5 Costs Associated with Pharmaceuticals for Seniors Act of 

6 2019’’ or the ‘‘RxCAP Act of 2019’’. 


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•S 475 IS

1 SEC. 2. ELIMINATION OF COST-SHARING ABOVE THE MEDI2 CARE PART D ANNUAL OUT-OF-POCKET 

3 THRESHOLD. 

4 (a) IN GENERAL.—Section 1860D–2(b)(4)(A) of the 

5 Social Security Act (42 U.S.C. 1395w–102(b)(4)(A)) is 

6 amended— 

7 (1) in clause (i)— 

8 (A) by redesignating subclauses (I) and 

9 (II) as items (aa) and (bb), respectively, and in10 denting appropriately; 

11 (B) by striking ‘‘subparagraph (B), with 

12 cost-sharing’’ and inserting the following: ‘‘sub13 paragraph (B)— 

14 ‘‘(I) for plan years 2006 through 

15 2019, with cost-sharing’’; 

16 (C) in item (bb), as redesignated by sub17 paragraph (A), by striking the period at the 

18 end and inserting ‘‘; and’’; and 

19 (D) by adding at the end the following new 

20 subclause: 

21 ‘‘(II) for plan year 2020 and sub22 sequent plan years, without any cost23 sharing.’’; and 

24 (2) in clause (ii)— 

25 (A) by striking ‘‘clause (i)(I)’’ and insert26 ing ‘‘clause (i)(I)(aa)’’; and 


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•S 475 IS

1 (B) by adding at the end the following new 

2 sentence: ‘‘The Secretary shall continue to cal3 culate the dollar amounts specified in clause 

4 (i)(I)(aa), including with the adjustment under 

5 this clause, after plan year 2019 for purposes 

6 of 1860D–14(a)(1)(D)(iii).’’. 

7 (b) CONFORMING AMENDMENTS TO LOW-INCOME

8 SUBSIDY.—Section 1860D–14(a) of the Social Security 

9 Act (42 U.S.C. 1395w–114(a)) is amended— 

10 (1) in paragraph (1)— 

11 (A) in subparagraph (D)(iii), by striking 

12 ‘‘1860D–2(b)(4)(A)(i)(I)’’ and inserting 

13 ‘‘1860D–2(b)(4)(A)(i)(I)(aa)’’; and 

14 (B) in subparagraph (E)— 

15 (i) in the heading, by inserting 

16 ‘‘PRIOR TO THE ELIMINATION OF SUCH

17 COST-SHARING FOR ALL INDIVIDUALS’’ 

18 after ‘‘THRESHOLD’’; and 

19 (ii) by striking ‘‘The elimination’’ and 

20 inserting ‘‘For plan years 2006 through 

21 2019, the elimination’’; and 

22 (2) in paragraph (2)(E)— 

23 (A) in the heading, by inserting ‘‘PRIOR TO

24 THE ELIMINATION OF SUCH COST-SHARING FOR

25 ALL INDIVIDUALS’’ after ‘‘THRESHOLD’’; 


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•S 475 IS

1 (B) by striking ‘‘Subject to’’ and inserting 

2 ‘‘For plan years 2006 through 2019, subject 

3 to’’; and 

4 (C) by striking ‘‘1860D–2(b)(4)(A)(i)(I)’’ 

5 and inserting ‘‘1860D–2(b)(4)(A)(i)(I)(aa)’’. 

Æ 


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