Capping Prescription Costs Act of 2025

This legislation aims to significantly limit the financial burden of prescription drug costs for consumers by establishing annual caps on out-of-pocket spending. It mandates that health plans ensure individuals and families face predictable expenses for covered prescription drugs. Specifically, for plan years beginning in 2026, the bill sets a maximum cost-sharing limit of $2,000 per year for each enrolled individual and $4,000 per year for each family . These limits will be adjusted annually for inflation in subsequent years, based on the medical care component of the consumer price index. The provisions apply broadly to qualified health plans under the Affordable Care Act, as well as to group health plans and health insurance issuers regulated under the Public Health Service Act, ERISA, and the Internal Revenue Code, taking effect for plan years beginning on or after January 1, 2026.