Fair Prescription Pricing Act of 2026

This legislative proposal seeks to significantly reduce out-of-pocket prescription drug costs for consumers by establishing a new limit on cost-sharing. Under this bill, for plan years beginning on or after its enactment, group health plans and health insurance issuers would be prohibited from imposing cost-sharing amounts, such as deductibles, coinsurance, and copayments , that exceed the nationwide average of consumer purchase prices for a given drug. This limitation applies to covered outpatient drugs dispensed by in-network pharmacies and uses a specific survey from the Social Security Act to determine the nationwide average price. Furthermore, the bill mandates that health plans and issuers ensure any pharmacy benefit managers (PBMs) they utilize also comply with this cost-sharing cap, preventing PBMs from circumventing the new rules. To implement these changes, the bill amends three key federal statutes: title XXVII of the Public Health Service Act , the Employee Retirement Income Security Act of 1974 (ERISA) , and the Internal Revenue Code of 1986 . These amendments collectively aim to provide broad coverage for this cost-sharing limitation across various health insurance plans and arrangements.