Title: RxCAP Act of 2019
Policy area: Health

Summary:
Reducing Existing Costs Associated with Pharmaceuticals for Seniors Act of 2019 or the RxCAP Act of 2019
This bill eliminates beneficiary cost-sharing above the Medicare prescription drug benefit's annual out-of-pocket threshold beginning in plan year 2020. Under current law, the Medicare prescription drug benefit provides coverage above that threshold only with cost-sharing in the form of either copayment or coinsurance.

[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[S. 475 Introduced in Senate (IS)]

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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.

    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 ``Reducing Existing Costs Associated 
with Pharmaceuticals for Seniors Act of 2019'' or the ``RxCAP Act of 
2019''.

SEC. 2. ELIMINATION OF COST-SHARING ABOVE THE MEDICARE PART D ANNUAL 
              OUT-OF-POCKET THRESHOLD.

    (a) In General.--Section 1860D-2(b)(4)(A) of the Social Security 
Act (42 U.S.C. 1395w-102(b)(4)(A)) is amended--
            (1) in clause (i)--
                    (A) by redesignating subclauses (I) and (II) as 
                items (aa) and (bb), respectively, and indenting 
                appropriately;
                    (B) by striking ``subparagraph (B), with cost-
                sharing'' and inserting the following: ``subparagraph 
                (B)--
                                    ``(I) for plan years 2006 through 
                                2019, with cost-sharing'';
                    (C) in item (bb), as redesignated by subparagraph 
                (A), by striking the period at the end and inserting 
                ``; and''; and
                    (D) by adding at the end the following new 
                subclause:
                                    ``(II) for plan year 2020 and 
                                subsequent plan years, without any 
                                cost-sharing.''; and
            (2) in clause (ii)--
                    (A) by striking ``clause (i)(I)'' and inserting 
                ``clause (i)(I)(aa)''; and
                    (B) by adding at the end the following new 
                sentence: ``The Secretary shall continue to calculate 
                the dollar amounts specified in clause (i)(I)(aa), 
                including with the adjustment under this clause, after 
                plan year 2019 for purposes of 1860D-
                14(a)(1)(D)(iii).''.
    (b) Conforming Amendments to Low-Income Subsidy.--Section 1860D-
14(a) of the Social Security Act (42 U.S.C. 1395w-114(a)) is amended--
            (1) in paragraph (1)--
                    (A) in subparagraph (D)(iii), by striking ``1860D-
                2(b)(4)(A)(i)(I)'' and inserting ``1860D-
                2(b)(4)(A)(i)(I)(aa)''; and
                    (B) in subparagraph (E)--
                            (i) in the heading, by inserting ``prior to 
                        the elimination of such cost-sharing for all 
                        individuals'' after ``threshold''; and
                            (ii) by striking ``The elimination'' and 
                        inserting ``For plan years 2006 through 2019, 
                        the elimination''; and
            (2) in paragraph (2)(E)--
                    (A) in the heading, by inserting ``prior to the 
                elimination of such cost-sharing for all individuals'' 
                after ``threshold'';
                    (B) by striking ``Subject to'' and inserting ``For 
                plan years 2006 through 2019, subject to''; and
                    (C) by striking ``1860D-2(b)(4)(A)(i)(I)'' and 
                inserting ``1860D-2(b)(4)(A)(i)(I)(aa)''.
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