I 
119TH CONGRESS 
1ST SESSION H. R. 2553 
To limit cost-sharing for prescription drugs, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
APRIL 1, 2025 
Mr. HORSFORD (for himself, Mr. FIGURES, Ms. STANSBURY, Mr. JOHNSON 
of Georgia, Ms. WATERS, Mrs. CHERFILUS-MCCORMICK, Mrs. HAYES, 
Mr. THOMPSON of Mississippi, and Ms. NORTON) introduced the fol-
lowing bill; which was referred to the Committee on Energy and Com-
merce, and in addition to the Committees on Education and Workforce, 
and Ways and Means, for a period to be subsequently determined by the 
Speaker, in each case for consideration of such provisions as fall within 
the jurisdiction of the committee concerned 
A BILL 
To limit cost-sharing for prescription drugs, and for other 
purposes. 
Be it enacted by the Senate and House of Representa-
tives 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 2025’’. 
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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 ‘‘, in-
cluding 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) 2026.—For plan years beginning in 
2026, the cost-sharing incurred under a health 
plan with respect to prescription drugs covered 
by the plan shall not exceed $2,000 per year for 
each enrolled individual, or $4,000 per year for 
each family. 
‘‘(B) 2027 AND LATER.— 
‘‘(i) IN GENERAL.—In the case of any 
plan year beginning in a calendar year 
after 2026, the limitation under this para-
graph shall be equal to the applicable dol-
lar amount under subparagraph (A) for 
plan years beginning in 2026, increased by 
an amount equal to the product of that 
amount and the medical care component of 
the consumer price index for all urban con-
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sumers (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 mul-
tiple of $5.’’. 
(b) GROUP HEALTH PLANS.— 
(1) PUBLIC HEALTH SERVICE ACT.—Part D of 
title XXVII of the Public Health Service Act (42 
U.S.C. 300gg–111 et seq.) is amended by inserting 
after section 2799A–5 (42 U.S.C. 300gg–115) the 
following: 
‘‘SEC. 2799A–6. CAP ON PRESCRIPTION DRUG COST-SHAR-
ING FOR GROUP HEALTH PLANS. 
‘‘A group health plan and health insurance issuer of-
fering group health insurance coverage shall ensure that 
any cost-sharing imposed under the plan or coverage with 
respect to prescription drugs covered by the plan or cov-
erage does not exceed the limitations provided for under 
paragraph (5) of section 1302(c) of the Patient Protection 
and Affordable Care Act.’’. 
(2) EMPLOYEE RETIREMENT INCOME SECURITY 
ACT.— 
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(A) IN GENERAL.—Subpart B of part 7 of 
subtitle B of title I of the Employee Retirement 
Income Security Act of 1974 (29 U.S.C. 1185 
et seq.) is amended by inserting after section 
720 (29 U.S.C. 1185i) the following: 
‘‘SEC. 721. CAP ON PRESCRIPTION DRUG COST-SHARING. 
‘‘A group health plan and health insurance issuer of-
fering group health insurance coverage shall ensure that 
any cost-sharing imposed under the plan or coverage with 
respect to prescription drugs covered by the plan or cov-
erage does not exceed the limitations provided for under 
paragraph (5) of section 1302(c) of the Patient Protection 
and Affordable Care Act.’’. 
(B) CLERICAL AMENDMENT.—The table of 
contents in section 1 of the Employee Retire-
ment Income Security Act of 1974 (29 U.S.C. 
1001 note) is amended by inserting after the 
item relating to section 720 the following: 
‘‘Sec. 721. Cap on prescription drug cost-sharing.’’. 
(3) INTERNAL REVENUE CODE OF 1986.— 
(A) IN GENERAL.—Subchapter B of chap-
ter 100 of the Internal Revenue Code of 1986 
is amended by inserting after section 9820 the 
following: 
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‘‘SEC. 9821. CAP ON PRESCRIPTION DRUG COST-SHARING. 
‘‘A group health plan shall ensure that any cost-shar-
ing imposed under the plan with respect to prescription 
drugs covered by the plan does not exceed the limitations 
provided for under paragraph (5) of section 1302(c) of 
the Patient Protection and Affordable Care Act.’’. 
(B) CLERICAL AMENDMENT.—The table of 
sections for subchapter B of chapter 100 of the 
Internal Revenue Code of 1986 is amended by 
inserting after the item relating to section 9820 
the following: 
‘‘Sec. 9821. Cap on prescription drug cost-sharing’’. 
(c) EFFECTIVE DATE.—The amendments made by 
subsections (a) and (b) shall take effect with respect to 
plan years beginning on or after January 1, 2026. 
Æ 
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