Capping Prescription Costs Act of 2025

This bill aims to significantly limit the out-of-pocket expenses individuals and families pay for prescription drugs. It amends the Patient Protection and Affordable Care Act (ACA) to introduce specific caps on prescription drug cost-sharing for qualified health plans. Beginning with plan years in 2026, the legislation mandates that an individual's annual cost-sharing for prescription drugs cannot exceed $2,000 , while a family's limit is set at $4,000 . For subsequent years, these caps will be adjusted annually based on the medical care component of the Consumer Price Index to account for inflation. The bill extends these new cost-sharing limitations to cover group health plans and health insurance issuers by amending the Public Health Service Act, the Employee Retirement Income Security Act (ERISA), and the Internal Revenue Code. These provisions are set to take effect for all plan years starting on or after January 1, 2026, ensuring broader application of the prescription drug cost caps.