# Capping Prescription Costs Act of 2021

This bill puts a monthly cap on how much people have to pay out of their own pockets for prescription drugs through their health insurance plans. Starting in 2023, individuals would pay no more than $250 per month for their medications, and families would pay no more than $500 per month total. This applies to most health insurance plans, whether you get coverage through your employer or buy it yourself on the marketplace.

The cap applies to what's called "cost-sharing"—that's the money you personally pay when you pick up a prescription, including copays (fixed amounts like $10 or $20 per prescription) and coinsurance (a percentage of the drug's cost). Once you hit the monthly limit, your insurance would cover the rest of your prescription costs for that month. The bill covers both individual insurance plans and group health plans offered by employers.

After 2023, the dollar amounts would increase each year based on inflation, specifically tied to how much medical costs go up. This means the caps would grow over time to keep pace with rising drug prices, but they'd always be rounded down to the nearest $5 to keep the numbers simple. The practical effect is that people who take expensive medications—whether for chronic conditions like diabetes or heart disease, or for newer specialty drugs—would have more predictable costs and wouldn't face unlimited out-of-pocket expenses for their prescriptions. This could be especially helpful for people who take multiple medications or those with serious illnesses that require costly drugs.

Capping Prescription Costs Act of 2021

Manning, Kathy E.

Capping Prescription Costs Act of 2021 This bill caps the monthly cost-sharing amount permitted for prescription drugs under qualified health plans and group health plans.